Individual provider Active NPI

Jordan Eckardt, DMD

  • Dentist
  • Fort Lauderdale, FL
National Provider Identifier
1023501293
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23487 Issued in FL
Practice address
530 NW 7TH Ave
Fort Lauderdale, FL 33311-8137
Phone
(954) 317-9221
NPI assigned
Jun 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23487 FL Primary

Addresses

Primary practice location

530 NW 7TH Ave
Fort Lauderdale, FL 33311-8137

Mailing address

530 NW 7TH Ave
Fort Lauderdale, FL 33311-8137
Phone (954) 317-9221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210708003005 FL Order and Referring Only - DentistPractitioner - Dentist 6507268893

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23487FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Dental Studio CurrentSince May 12, 2024 Accepting new patients
Comfortable Care Dental Health Professionals. P.a. Past Accepting new patients

Locations

530 NW 7th Ave
Fort Lauderdale, FL 33311
Phone (954) 317-9221

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1023501293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NW 7TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333118137",
            "telephone_number": "954-317-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NW 7TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333118137",
            "telephone_number": "954-317-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKARDT",
        "first_name": "JORDAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.