Cody Jordan

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

S221 Issued in MN

Practice address

5675 26TH Ave S Ste 116
Fargo, ND 58104-8599

Phone

(701) 699-6966

Fax

(701) 929-5441

NPI assigned

Mar 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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.

• Wisdom Tooth PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fargo, ND
  • NPI 1194679704
  NPD Authorized official

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1043847874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 26TH AVE S STE 116",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048599",
            "telephone_number": "701-699-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 26TH AVE S STE 116",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048599",
            "telephone_number": "701-699-6966",
            "fax_number": "701-929-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "S221",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ND",
            "license": "2518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laci Jones, RN, IBCLC
• Angela Kaye Joneson, CNP
• Marlys Kay Joramo
• Renee Jordahl
• Andrew A Jordan, MD
• Elizabeth Rose Jordan, DC
• Ivy L Jordan, DPT
• Sarah Jordan
• Erin Jore
• Jorgensen Chiropractic, PC (Red River Wellness)

• Oral and Maxillofacial Surgery (Dentist) in Fargo, ND
• Providers in Fargo, ND by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.