Thomas Jordan, DDS
Individual provider Active NPI Dentist · Kaneohe Bay, HI
NPI 1164414728 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1164414728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 48925 (CA)
- Practice address
- 21St Dental Company
Building 3089 D Street
Kaneohe Bay, HI 96863 - Phone
- (808) 257-3100
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48925 | CA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 48925 | CA | Yes |
Addresses
Primary practice location
21St Dental Company
Building 3089 D Street
Kaneohe Bay, HI 96863
Mailing address
Building 3089 D Street
21St Dental Company
Kaneohe Bay, HI 96863
Phone (808) 257-3100
Other providers in Kaneohe Bay, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.