Jeffrey Howard Fordice, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9297 Issued in MN

Practice address

1120 Birch St
Fairmont, MN 56031-4418

Phone

(507) 238-4276

Fax

(507) 238-5496

NPI assigned

Apr 18, 2006

Last updated

Feb 25, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in MN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeff Fordice DDS LLC

  • General Practice Dentistry
  • Fairmont, MN
  • NPI 1417227828
  NPD (past)

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1083679732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 BIRCH ST",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314418",
            "telephone_number": "507-238-4276",
            "fax_number": "507-238-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BIRCH ST",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314418",
            "telephone_number": "507-238-4276",
            "fax_number": "507-238-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDICE",
        "first_name": "JEFFREY",
        "middle_name": "HOWARD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D9297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairmont Orthopedics & Sports Medicine, PA (Center for Specialty Care)
• Samantha Augusta Farnum, APRN
• Robert Fernandez, MD
• Five Lakes Dental Studio LLC
• Daniel Jeffrey Fordice, D.M.D.
• Taylor Forstner, DDS
• Amanda J Forstrom, PT
• Robert Friese, OD
• Michelle Larae Geerdes, OTR/L
• Reed E Gethmann

• General Practice Dentistry in Fairmont, MN
• Providers in Fairmont, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.