Connisha Jordan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12014167A Issued in IN

Practice address

1552 E Wabash St Ste a
Frankfort, IN 46041-2783

Phone

(765) 659-3443

NPI assigned

Jul 11, 2023

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Urgent Dental Center Frankfort LLC

  • General Practice Dentistry
  • Frankfort, IN
  • NPI 1063167674
  NPD

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1407534209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 HARVEST MOON LN",
            "city": "WHITESTOWN",
            "state": "IN",
            "postal_code": "460750050",
            "telephone_number": "260-425-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 E WABASH ST STE A",
            "city": "FRANKFORT",
            "state": "IN",
            "postal_code": "460412783",
            "telephone_number": "765-659-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CONNISHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014167A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda N Jakes, PHARMD
• Kelcy Jarrell
• Shaojuan Jia, PT
• Marie Johnson, N.P.
• Skylar Johnson
• Sarai Juarez
• Julie D. Kinsler, DDS, LLC
• Abigail Kauffman
• Kay Eigenbrod, MD
• David G. Keck, O.T.R.

• General Practice Dentistry in Frankfort, IN
• Providers in Frankfort, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.