Thomas Jordan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00202868 Issued in CO

Practice address

1921 Sheridan Blvd Unit F
Edgewater, CO 80214-1315

Phone

(303) 202-3550

NPI assigned

Jul 27, 2016

Last updated

Jul 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomas a Jordan DDS LLC

  dba Grant Dental Plaza

  • Dental Clinic/Center
  • Omaha, NE
  • NPI 1972238509
  NPD Authorized official
• Edgewater Modern Dentistry and Orthodontics, LLP

  dba Edgewater Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • Edgewater, CO
  • NPI 1780962589
  NPD (past)

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1255884045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 SHERIDAN BLVD UNIT F",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141315",
            "telephone_number": "303-202-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 SHERIDAN BLVD UNIT F",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141315",
            "telephone_number": "303-202-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00202868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeleine Glodowski
• Sydney Hecht, BSN, RN
• Caroline Pauline High, MS, CCC-SLP
• Patrick Joseph Hoblitzell, DMD
• Christian Hodge, PHARM D
• Caroline Elizabeth Kucha, OD
• Emily Ladd, LSW
• Lakefront Eye Care, LLC
• Kathy Le, DDS
• Michael E Long, PHARMD

• General Practice Dentistry in Edgewater, CO
• Providers in Edgewater, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.