Jordan Nguyen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7996 Issued in OK

Practice address

19 W Interstate Pkwy
Shawnee, OK 74804-1331

Phone

(405) 275-0675

NPI assigned

Mar 27, 2024

Last updated

Jul 24, 2025By 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 TN

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

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.

• Okc Dental Health Associates, P.C.

  dba MyDentist-Shawnee

  • General Practice Dentistry
  • Shawnee, OK
  • NPI 1154741007
  NPD (past)

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1326898602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 W INTERSTATE PKWY",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041331",
            "telephone_number": "405-261-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W INTERSTATE PKWY",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041331",
            "telephone_number": "405-275-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JORDAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "7996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lila Nevrekar, M.D.
• New Century Hospice, Inc (Heartland Hospice (Shawnee))
• Jill Newman
• Lauren Newman, LPC
• Martine Welehelale Ngamelue-Kouemo, ARNP
• Kimberly Phan Nguyen
• Brock Wesley Nichols, DDS
• Betty Jane Nicholson, LPN, RN
• Emily Brooke Nickerson, BA
• David Eugene Nicklas, DPH

• Dentist in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.