Jordan Willner, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN25159 Issued in FL

Practice address

12350 SW 127TH Ave
Miami, FL 33186-6595

Phone

(516) 477-1762

NPI assigned

May 17, 2020

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 MA

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": "1589673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1447872015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 COLLINS AVE APT 1509",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403278",
            "telephone_number": "516-477-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12350 SW 127TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866595",
            "telephone_number": "516-477-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLNER",
        "first_name": "JORDAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-17",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN25159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kemauri Willis
• Samantha Willis, CNA, HHA
• Wayneisha Trreise Willliams, MS., CF - SLP
• Willmig Medical Center
• Joseph Willmitch, PA
• Jennifer Rose Willoughby, PHARMD
• Willow Tree Community Center Corp
• Willsand Home Health Agency, Inc
• Willson Pharmacy Inc
• Bryan Ross Wilner, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Miami, FL
• Providers in Miami, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.