NPIMap

Organization Active NPI

Jordan Dental Group Inc

  • General Practice Dentistry
  • Carlsbad, CA
National Provider Identifier
1245405877
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28010 Issued in CA
Legal business name
JORDAN DENTAL GROUP INC
Practice address
6120 Paseo del Norte
K1
Carlsbad, CA 92011-1150
Phone
(760) 438-0948
Fax
(760) 438-7821
NPI assigned
Apr 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Authorized official

Name
Melissa Sue Nelson, R.D.A.
Title
Office Coordinator
Phone
(760) 438-0948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 28010 CA Primary

Addresses

Primary practice location

6120 Paseo del Norte
K1
Carlsbad, CA 92011-1150

Mailing address

PO Box 130939
Carlsbad, CA 92013-0939
Phone (760) 438-0948

Other names 1

  • Bruce M Jordan DDS, Inc Former legal business name

National Provider Directory

National Provider Directory

Locations

6120 Paseo del Norte
Ste K1
Carlsbad, CA 92011
Phone (760) 438-0948

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1245405877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130939",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920130939",
            "telephone_number": "760-438-0948",
            "fax_number": "760-438-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 PASEO DEL NORTE",
            "address_2": "K1",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111150",
            "telephone_number": "760-438-0948",
            "fax_number": "760-438-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN DENTAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "760-438-0948",
        "authorized_official_credential": "R.D.A."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruce M Jordan DDS, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.