Jordan Dental PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27692 Issued in TX

Legal business name

JORDAN DENTAL PA

Practice address

415 S Airport Dr
Weslaco, TX 78596-5395

Phone

(720) 236-4651

NPI assigned

Feb 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Khaldoon AbidNPI 1386917607

Title

DDS/Owner

Phone

(720) 236-4651

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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

• Khaldoon Abid, DDS

  • Dentist
  • Weslaco, TX
  • NPI 1386917607
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1174947899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S AIRPORT DR",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785965395",
            "telephone_number": "720-236-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S AIRPORT DR",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785965395",
            "telephone_number": "720-236-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-17",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "ABID",
        "authorized_official_first_name": "KHALDOON",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "720-236-4651",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizana Jimenez, RN
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• Christina Prueger Johnson, M.D.
• Diana Rachel Jolles, CNM
• Jorge F Lozano MD PA
• Jorge Saenz M.D.P.a.
• Jose D Bejarano MD PA
• Jose M Rojas
• Jose Roman Crna PLLC

• General Practice Dentistry in Weslaco, TX
• Providers in Weslaco, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.