Jeffrey Lamont Jordan, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

12008913 Issued in IN

Practice address

5963 Calais Court
6008 East 46TH St.
Indianapolis, IN 46220

Phone

(317) 254-5601

NPI assigned

Apr 12, 2007

Last updated

Jul 8, 2007By 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 IN

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

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.

• Healthy Kids First

  • Dentist
  • Indianapolis, IN
  • NPI 1861657579
  NPD (past) Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093939654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5963 CALAIS COURT",
            "address_2": "5963 CALAIS COURT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46220",
            "telephone_number": "317-254-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5963 CALAIS COURT",
            "address_2": "6008 EAST 46TH ST.",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46220",
            "telephone_number": "317-254-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JEFFREY",
        "middle_name": "LAMONT",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyraya'H Jonesa, RBT
• Kenneth A. Jongsma, D.O.
• Lauren Joray
• David McGrain Jordan II, DDS
• Jana Jordan, MOT
• Jennifer Jordan, SLP
• Jennifer Kathryn Jordan
• Kanisha Jordan
• Kara Monet Jordan, CNA,HHA
• Kayla Jordan

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.