Benjamin Slader Jordan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11056 Issued in KY

Practice address

4420 Dixie Hwy Ste 110
Louisville, KY 40216-2986

Phone

(502) 305-2534

NPI assigned

Aug 23, 2022

Last updated

Sep 13, 2024By 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 3

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1598484768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 STANFORD ST APT A",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 DIXIE HWY STE 110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162986",
            "telephone_number": "502-305-2534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Winners Cir",
            "address_purpose": "LOCATION",
            "city": "Topsham",
            "state": "ME",
            "postal_code": "040861727",
            "country_code": "US",
            "telephone_number": "207-725-1755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "BENJAMIN",
        "middle_name": "SLADER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11056",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN5005",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Jones, MD
• Whitney Jones, PHARMD, BCPS
• Jonet Wright LLC
• Roberta Jonkers
• Loretta Lynn Jophlin, MD, PHD
• Carolyn Jordan, M.S, CCC-SLP
• Gary Lee Jordan, COTA/L
• Lisa Renee Jordan, P.T.
• Symone Jordan
• Jeffrey R Jorden, MD

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.