Jordan Richardson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8122 Issued in NV

Practice address

6525 N Decatur Blvd Ste 150
Las Vegas, NV 89131-2993

Phone

(702) 577-1941

NPI assigned

May 25, 2023

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1497447445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 W ALEXANDER RD UNIT 2151",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891293520",
            "telephone_number": "702-901-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 N DECATUR BLVD STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891312993",
            "telephone_number": "702-577-1941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6485 N Decatur Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891312989",
            "country_code": "US",
            "telephone_number": "702-901-9918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JORDAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "8122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freddie Richardson
• Gary Dean Richardson, DDS
• Gerald Charles Richardson
• Jaclyn Richardson, DMD
• Janice Richardson
• Kehaulani Richardson, RBT
• Kimberly M Richardson
• Kristi Richardson
• Lela Richardson
• Leslie Richardson, D.C.

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.