Thomas David Jordan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15009 Issued in MO

Practice address

346 Fort Zumwalt SQ
O Fallon, MO 63366-3065

Phone

(636) 978-6400

Fax

(636) 980-1125

NPI assigned

Feb 25, 2013

Last updated

Feb 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MO

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.

• Thomas D. Jordan, DDS, PC

  dba DawnDENTAL Centers

  • General Practice Dentistry
  • O'Fallon, MO
  • NPI 1700932464
  NPD (past) Authorized official
• Blake Ferando DMD LLC

  • General Practice Dentistry
  • O'Fallon, MO
  • NPI 1750868915
  NPD (past)

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1578803706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 FORT ZUMWALT SQ",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663065",
            "telephone_number": "636-978-6400",
            "fax_number": "636-980-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 FORT ZUMWALT SQ",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663065",
            "telephone_number": "636-978-6400",
            "fax_number": "636-980-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "THOMAS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "15009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jones Legacy Home Health, LLC
• Courtney Paige Jones
• Kevin Jones
• Kristine Marie Jones, LPC
• Leah Suzanne Jones, FNP
• Bryan A Joseph, DC
• Olivia Anna Joseph, DC
• Joy Counseling Services, LLC
• Joyful Hearts Health Services LLC
• JS Industries, Inc.

• General Practice Dentistry in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.