Organization Active NPI

John R Jordan DMD PL

  • Dentist
  • West Palm Beach, FL
National Provider Identifier
1114047073
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6849 Issued in FL
Legal business name
JOHN R JORDAN DMD PL
Practice address
1515 N Flagler Dr
Ste #360
West Palm Beach, FL 33401-3428
Phone
(561) 659-1688
Fax
(561) 659-5658
NPI assigned
Apr 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John R Jordan, DMD
Title
President
Phone
(561) 659-1688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6849 FL Primary

Addresses

Primary practice location

1515 N Flagler Dr
Ste #360
West Palm Beach, FL 33401-3428

Mailing address

1515 N Flagler Dr
Ste #360
West Palm Beach, FL 33401-3428
Phone (561) 659-1688

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114047073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N FLAGLER DR",
            "address_2": "STE #360",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013428",
            "telephone_number": "561-659-1688",
            "fax_number": "561-659-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N FLAGLER DR",
            "address_2": "STE #360",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013428",
            "telephone_number": "561-659-1688",
            "fax_number": "561-659-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R JORDAN DMD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-659-1688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "6849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.