Clint R Jordan, D.D.S.
Individual provider Active NPI General Practice Dentistry · Merna, NE
NPI 1215260286 · NPPES record last updated Sep 22, 2011
Key facts
- NPI
- 1215260286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6837 (NE)
- Practice address
- 130 West Old Highway 2
Merna, NE 68856 - Phone
- (308) 643-2255
- NPI assigned
- Sep 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 6837 | NE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jordan Dental /Self | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6837 | NE | Yes |
Addresses
Primary practice location
130 West Old Highway 2
Merna, NE 68856
Mailing address
44080 Dr 796
Broken Bow, NE 68822-4256
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10026061400 | Medicaid | NE |
Other providers in Merna, NE
- Anselmo Merna School District 15
- Donna Rae Downey
- James Bradley Foster
- Jordan Dental /Self
- Merna Emergency Medical Services
- Hannah Marie Parsons
- Solomon Family Dentistry, P.C.
- Village of Merna
All providers in Merna, NE · General Practice Dentistry in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2011. 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.