Individual provider Active NPI

Jordyn Ann Ebert, DMD

  • Dentist
  • Macon, GA
National Provider Identifier
1609793082
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN124222 Issued in GA
Practice address
4705 Northside Dr Ste 100
Macon, GA 31210-2241
Phone
(478) 207-6939
NPI assigned
Jul 6, 2026
Last updated
Jul 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN124222 GA Primary

Addresses

Primary practice location

4705 Northside Dr Ste 100
Macon, GA 31210-2241

Mailing address

4705 Northside Dr Ste 100
Macon, GA 31210-2241
Phone (478) 207-6939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dental Arts, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1783296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1609793082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 NORTHSIDE DR STE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102241",
            "telephone_number": "478-207-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 NORTHSIDE DR STE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102241",
            "telephone_number": "478-207-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "JORDYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN124222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.