Active NPI
Andrew Jordan, DDS
- Dentist
- Mason, OH
National Provider Identifier
1679772180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30022568
- Practice address
- 5841 Snider Road
Mason, OH 45040 - Phone
- (513) 777-9117
- Fax
- (513) 777-9111
- NPI assigned
- Jul 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30022568 | OH | Primary |
Addresses
Primary practice location
5841 Snider Road
Mason, OH 45040
Mailing address
5841 Snider Road
Mason, OH 45040
Phone (513) 777-9117
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30022568 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afinia Dental - Killgore & Shaftel Inc. | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Mason, OH
- NPI 1730495193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539907200000",
"number": "1679772180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5841 SNIDER ROAD",
"city": "MASON",
"state": "OH",
"postal_code": "45040",
"telephone_number": "513-777-9117",
"fax_number": "513-777-9111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 SNIDER ROAD",
"city": "MASON",
"state": "OH",
"postal_code": "45040",
"telephone_number": "513-777-9117",
"fax_number": "513-777-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-13",
"last_updated": "2018-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30022568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mason, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.