Jordan Michael Jenkins, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12012319A Issued in IN

Practice address

1941 W Boulevard
Kokomo, IN 46902-6027

Phone

(765) 453-6200

NPI assigned

Jun 6, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• J Jenkins Family Dentistry, LLC

  • Dental Clinic/Center
  • Kokomo, IN
  • NPI 1437743127
  NPD Authorized official
• Kluth Family Dentistry Inc.

  • General Practice Dentistry
  • Alexandria, IN
  • NPI 1053402198
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1003296823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20251 JAMES RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460629048",
            "telephone_number": "812-607-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026027",
            "telephone_number": "765-453-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2204 S Park Ave",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "IN",
            "postal_code": "460018059",
            "country_code": "US",
            "telephone_number": "765-724-7729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-06",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21241",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012319A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista L Jarvis, RBT
• Jatinder N Kaushal MD Inc
• Sridhar Jatla, MD
• Jedeye LLC
• Justin Jefferson
• Lyle Ray Jenkins
• Sarah Jester
• Karyn Jett, NP
• Savanna Jilg, OTR
• Eric Johanning

• General Practice Dentistry in Kokomo, IN
• Providers in Kokomo, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.