Individual provider Active NPI

Jordan R Siegel

  • Endodontics
  • Silver Spring, MD
National Provider Identifier
1194385161
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
18525 Issued in MD
Practice address
804 Pershing Dr Ste 102
Silver Spring, MD 20910-4436
Phone
(301) 562-9455
NPI assigned
Jun 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DEN2000507 DC
Endodontics 1223E0200X DR-3119 HI
Endodontics 1223E0200X 18525 MD Primary

Addresses

Primary practice location

804 Pershing Dr Ste 102
Silver Spring, MD 20910-4436

Mailing address

8225 Osage LN
Bethesda, MD 20817-4405
Phone (301) 787-2156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN2000507DCMDEndodontist
DR-3119HIMDEndodontist
18525MDMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1194385161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8225 OSAGE LN",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208174405",
            "telephone_number": "301-787-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 PERSHING DR STE 102",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104436",
            "telephone_number": "301-562-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "JORDAN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "DC",
            "license": "DEN2000507",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "HI",
            "license": "DR-3119",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "18525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.