Active NPI
Jeffrey Yngve Nordlander, DDS
- Prosthodontics
- Sacramento, CA
National Provider Identifier
1205046299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 30782
- Practice address
- 6409 Folsom Blvd # 2
Sacramento, CA 95819-4620 - Phone
- (916) 454-0855
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 30782 | CA | Primary |
Addresses
Primary practice location
6409 Folsom Blvd # 2
Sacramento, CA 95819-4620
Mailing address
6409 Folsom Blvd # 2
Sacramento, CA 95819-4620
Phone (916) 454-0855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 2, 2016 through May 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30782 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205046299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6409 FOLSOM BLVD # 2",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958194620",
"telephone_number": "916-454-0855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6409 FOLSOM BLVD # 2",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958194620",
"telephone_number": "916-454-0855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDLANDER",
"first_name": "JEFFREY",
"middle_name": "YNGVE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "30782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.