NPIMap

Organization Active NPI

Jourdan Family Dentistry

  • Dentist
  • Vinita, OK
National Provider Identifier
1447426317
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5381 Issued in OK
Legal business name
JOURDAN FAMILY DENTISTRY
Practice address
120A W Delaware Ave
Vinita, OK 74301-4224
Phone
(918) 256-6831
NPI assigned
May 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Thomas B Jourdan, D.D.S.NPI 1912051400
Title
Dentist
Phone
(918) 256-6831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5381 OK Primary

Addresses

Primary practice location

120A W Delaware Ave
Vinita, OK 74301-4224

Mailing address

120A W Delaware Ave
Vinita, OK 74301-4224
Phone (918) 256-6831

Other identifiers 3

IdentifierTypeStateIssuer
803040COtherOKUNITED CONCORDIA
263477085001OtherOKBLUE CROSS BLUE SHIELD
OK5381OtherOKDELTA DENTAL

National Provider Directory

National Provider Directory

Locations

120 W Delaware Ave
Ste A
Vinita, OK 74301
Phone (918) 256-6831

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1447426317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120A W DELAWARE AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014224",
            "telephone_number": "918-256-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120A W DELAWARE AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014224",
            "telephone_number": "918-256-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURDAN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "JOURDAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "918-256-6831",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "5381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "803040C",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "263477085001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "OK5381",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinita, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.