Katie Jordan, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2902012177 Issued in MI

Practice address

18190 Rainbow Dr
Lathrup Village, MI 48076-4518

Phone

(313) 505-6665

Fax

(248) 864-8648

NPI assigned

Oct 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Henderson & Associates DDS PC Dba Jolly Smiles Mobile Dental Services

  • Dental Clinic/Center
  • Detroit, MI
  • NPI 1770244972

  Dental Hygienist

  NPD (past)

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1033686464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18190 RAINBOW DR",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764518",
            "telephone_number": "313-505-6665",
            "fax_number": "248-864-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18190 RAINBOW DR",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764518",
            "telephone_number": "313-505-6665",
            "fax_number": "248-864-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KATIE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902012177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerroldherman,D.D.S.,P.C.
• Xinlan Jiang
• Pauline Jiddou, D.D.S.
• John R. Trotter II MD Medical Services PLLC
• Joyce Jones
• Joyous Assisted Living
• Ousman Kamara
• Riyadh P Kasmikha, M.D.
• Khayri Kassab
• Alexander Kasshamoun, DDS

• Dental Hygienist in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Dental Hygienist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.