Austin Jordan

Primary specialty

DentistTaxonomy code 122300000X

License

D-0007050-C1 Issued in AL

Practice address

2455 Medical Center Pkwy
Selma, AL 36701-7756

Phone

(334) 872-0486

NPI assigned

Jun 9, 2022

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

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.

• Coastal Dental LLC

  • Dental Clinic/Center
  • Gulf Shores, AL
  • NPI 1518766401
  NPD Authorized official
• Tucker Family Dentistry, P.C.

  • General Practice Dentistry
  • Selma, AL
  • NPI 1992083117
  NPD (past)

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1477282994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 HOOPER DR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016524",
            "telephone_number": "251-362-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 MEDICAL CENTER PKWY",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367017756",
            "telephone_number": "334-872-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D-0007050-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Dillard MD
• Sankung Jobarteh, PHARM.D
• Richard Keith Johnson, MD
• Joint Adjust
• Lashana Faye Jones, DIRECTOR
• Ladonnaa Renee Jordon
• Joseph H Carstarphen
• Julie R. Sams, DMD, LLC
• Saima Kanwal, MD
• Theresa Kemp

• Dentist in Selma, AL
• Providers in Selma, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.