Robert Dalson Jordan, DDS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

DS0000004461 Issued in TN

Practice address

109 S Northshore Dr
Suite 404
Knoxville, TN 37919-4939

Phone

(865) 588-9589

Fax

(865) 588-9865

NPI assigned

Nov 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487725727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S NORTHSHORE DR",
            "address_2": "SUITE 404",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194939",
            "telephone_number": "865-588-9589",
            "fax_number": "865-588-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S NORTHSHORE DR",
            "address_2": "SUITE 404",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194939",
            "telephone_number": "865-588-9589",
            "fax_number": "865-588-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ROBERT",
        "middle_name": "DALSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "TN",
            "license": "DS0000004461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Whitlock Jordan, M.C.D. CCC-SLP
• John Jordan, OD
• Mary Elizabeth Jordan, DO
• Merianne Jordan, DPT
• Nathaniel John Jordan, DO
• Robert S Jordan, DPH
• Sean Alexander Jordan, MD
• Valerie Jordan, APRN
• Mark Steven Jordon, M.D.
• Barbara Jorgensen, P.T.

• Oral and Maxillofacial Pathology Dentistry in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Oral and Maxillofacial Pathology Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.