NPIMap

Organization Active NPI

Jordan Dental Corporation

  • General Practice Dentistry
  • Woodland Hills, CA
National Provider Identifier
1427465863
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28575 Issued in CA
Legal business name
JORDAN DENTAL CORPORATION
Practice address
23111 Ventura Blvd
Suite 104
Woodland Hills, CA 91364
Phone
(818) 225-7768
Fax
(818) 225-1138
NPI assigned
Jul 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Dr. Timothy Harold Jordan, DMD
Title
President
Phone
(818) 225-7768

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 28575 CA Primary

Addresses

Primary practice location

23111 Ventura Blvd
Suite 104
Woodland Hills, CA 91364

Mailing address

23111 Ventura Blvd. Suite 104
Woodland Hills, CA 91364
Phone (818) 225-7768

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1427465863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23111 VENTURA BLVD. SUITE 104",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91364",
            "telephone_number": "818-225-7768",
            "fax_number": "818-225-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23111 VENTURA BLVD",
            "address_2": "SUITE 104",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91364",
            "telephone_number": "818-225-7768",
            "fax_number": "818-225-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-225-7768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.