Individual provider Active NPI

Catrinel Elena Jordan, DDS, MS

  • Dental Clinic/Center
  • Prairieville, LA
National Provider Identifier
1104176353
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6275 Issued in LA
Practice address
16270 Airline Hwy Ste B
Prairieville, LA 70769-4589
Phone
(225) 673-1557
Fax
(225) 673-6815
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Dental Clinic/Center 261QD0000X 6275 LA Primary

Addresses

Primary practice location

16270 Airline Hwy Ste B
Prairieville, LA 70769-4589

Mailing address

16270 Airline Hwy Ste B
Prairieville, LA 70769-4589
Phone (225) 673-1557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20151111000556 LA Order and Referring Only - DentistPractitioner - Dentist 5991015562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6275LAMDDental Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Care Group Dental CurrentSince Sep 12, 2012 Accepting new patients

Locations

16270 Airline Hwy
Ste B
Prairieville, LA 70769
Phone (225) 673-1557

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1104176353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16270 AIRLINE HWY STE B",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694589",
            "telephone_number": "225-673-1557",
            "fax_number": "225-673-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16270 AIRLINE HWY STE B",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694589",
            "telephone_number": "225-673-1557",
            "fax_number": "225-673-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CATRINEL",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "6275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairieville, LA

Sources for this page

Verify at the official NPI Registry.