William Jordan, D.M.D., F.A.G.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6424 Issued in OR

Practice address

18789 SW Boones Ferry Rd
Ste 4
Tualatin, OR 97062-8412

Phone

(503) 692-6535

Fax

(503) 691-2831

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Bill Jordan Professional name

Medicare fee-for-service enrollment

Enrolled in OR

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

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366474678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18789 SW BOONES FERRY RD",
            "address_2": "STE 4",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628412",
            "telephone_number": "503-692-6535",
            "fax_number": "503-691-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18789 SW BOONES FERRY RD",
            "address_2": "STE 4",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628412",
            "telephone_number": "503-692-6535",
            "fax_number": "503-691-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D., F.A.G.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "6424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BILL",
            "last_name": "JORDAN",
            "prefix": "DR.",
            "credential": "D.M.D., F.A.G.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sharon Johnston, RN
• Sabrina F Jones-Wyatt, BSN, RN
• Jean Marie Jones, LMT
• Melody Becker Jones, MSN, PMHNP-BC
• Joseph Edward Jordan, PHARM.D.
• Josh Borrelli, Psy.D., LLC
• Amber Lee Judge, PHARM.D
• Timothy David Kadlecek, DO
• Kaiser Foundation Health Plan of the Northwest
• Kaiser Foundation Health Plan of the Northwest

• General Practice Dentistry in Tualatin, OR
• Providers in Tualatin, OR by specialty
• General Practice Dentistry in Oregon

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.