Provider Demographics
NPI:1447429428
Name:LADAN, VICTOR JACK (DDS)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JACK
Last Name:LADAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHIP
Other - Middle Name:
Other - Last Name:LADAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7233 PEARL ROAD
Mailing Address - Street 2:CHIP LADAN DDS
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130
Mailing Address - Country:US
Mailing Address - Phone:440-843-7540
Mailing Address - Fax:440-842-4060
Practice Address - Street 1:7233 PEARL ROAD
Practice Address - Street 2:CHIP LADAN DDS
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130
Practice Address - Country:US
Practice Address - Phone:440-843-7540
Practice Address - Fax:440-842-4060
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30017105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist