Todd S Jordan, DDS, PA

Primary specialty

DentistTaxonomy code 122300000X

License

6575 Issued in NC

Legal business name

TODD S JORDAN, DDS, PA

Practice address

921 Main St
North Wilkesboro, NC 28659-4215

Phone

(336) 667-2201

Fax

(336) 903-1652

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Todd Sims Jordan, D.D.S.NPI 1508081563

Title

President

Phone

(336) 667-2201

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Sims Jordan, D.D.S.

  • General Practice Dentistry
  • Greenville, NC
  • NPI 1508081563
  NPD (past) Authorized official

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154533859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 MAIN ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594215",
            "telephone_number": "336-667-2201",
            "fax_number": "336-903-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 MAIN ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594215",
            "telephone_number": "336-667-2201",
            "fax_number": "336-903-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD S JORDAN, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "SIMS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-667-2201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "6575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in North Wilkesboro, NC
• Providers in North Wilkesboro, NC by specialty
• Dentist in North Carolina

• 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.