Marvel Jordan

NPI 1730149204 · on the registry since 2006

Practice

Address: 153 Cesar Chavez St
Saint Paul, MN 55107
Phone: (651) 222-1816
Fax: (651) 602-7517
Organisation at this address: Quest Diagnostics Llc Il
Bright Smiles Dental Program
West Side Community Health Services Inc
West Side Community Health Services, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 87

Registry record

Primary taxonomy: 104100000X
104100000X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2026-07-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota