Jorge O Cordova, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI-19630 Issued in NJ

Practice address

272 US Highway 46
Rockaway, NJ 07866-3826

Phone

(973) 627-2121

Fax

(973) 627-2088

NPI assigned

Oct 17, 2006

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 NJ

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jorge O Cordova Inc

  dba J C Dental

  • General Practice Dentistry
  • Rockaway, NJ
  • NPI 1063593358
  NPD (past) Authorized official

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548341886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 US HIGHWAY 46",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078663826",
            "telephone_number": "973-627-2121",
            "fax_number": "973-627-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 US HIGHWAY 46",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078663826",
            "telephone_number": "973-627-2121",
            "fax_number": "973-627-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "JORGE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI-19630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisset D Coletti Orrego
• Laurel L Colombo
• Compassionate Care Hospice of Northern New Jersey, LLC
• Angela R. Constantino, LCSW
• John Anthony Cordasco, DMD
• Meryl Catherine Coriell, PHARMD
• Reimond Jose I Costa
• Dario J Cunico, DDS
• Melissa Lynne D'Addario
• Hellen Paula Gontijo Da Silva, LPC

• General Practice Dentistry in Rockaway, NJ
• Providers in Rockaway, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.
• 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.