Edward T Jordan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412867 Issued in VA

Practice address

1612 Huguenot Rd
Midlothian, VA 23113-2427

Phone

(804) 794-9789

NPI assigned

Jun 16, 2010

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

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.

Opted out of Medicare

Yes, effective Sep 23, 2016 through Sep 23, 2026

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Virginia Family Dentistry PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1750435970
  NPD (past)

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1669793402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 HUGUENOT RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132427",
            "telephone_number": "804-794-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 HUGUENOT RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132427",
            "telephone_number": "804-794-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "EDWARD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronique Jones, BS, MA, QDDP
• Callie Jongbloedt
• Jordan Rosen OD LTD
• Amanda Grady Jordan, MED,BCBA
• Danielle Dee Jordan
• Kera D Jordan, M.S. CCC-SLP
• Mahala Jordan, LPC
• Eric Lawrence Jorde, PT
• Jose E. Gallegos, D.D.S., P.C.
• Bindu Joseph, AGNP-C

• General Practice Dentistry in Midlothian, VA
• Providers in Midlothian, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.