Jordan Louise Gardner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14899 Issued in MN

Practice address

10700 France Ave S Ste 102
Bloomington, MN 55431-3693

Phone

(952) 679-3531

NPI assigned

Jun 16, 2023

Last updated

Jun 16, 2023By the provider in NPPES

Sex

Female

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Bloomington Smiles Dentistry, PC

  dba Bloomington Smiles Denitstry

  • General Practice Dentistry
  • Bloomington, MN
  • NPI 1710344494
  NPD (past)

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1093490120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 22ND AVE S APT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043131",
            "telephone_number": "507-676-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 FRANCE AVE S STE 102",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313693",
            "telephone_number": "952-679-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JORDAN",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Mary Gallogly
• Michael Jeffrey Garbow, MS LP
• Julieta Garcia-Cordova
• Kaylee Juana Garcia, CNP
• Gardenview Home Health LLC
• Pamela A Gardner, PT
• Alexandra Gargaro
• Isabelle Nicole Garlington
• Elizabeth Garlough
• Rachael Garvelink

• General Practice Dentistry in Bloomington, MN
• Providers in Bloomington, 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 Jun 16, 2023; 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.