NPIMap

Organization Active NPI

Thomas D. Jordan, DDS, PC

  • General Practice Dentistry
  • O Fallon, MO
National Provider Identifier
1700932464
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015009 Issued in MO
Legal business name
THOMAS D. JORDAN, DDS, PC
Doing business as
DawnDENTAL Centers
Practice address
346 Fort Zumwalt SQ
O Fallon, MO 63366-3065
Phone
(636) 978-6400
Fax
(636) 980-1125
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Authorized official

Name
Dr. Thomas Jordan, DDSNPI 1578803706
Title
Officer
Phone
(636) 978-6400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 015009 MO Primary

Addresses

Primary practice location

346 Fort Zumwalt SQ
O Fallon, MO 63366-3065

Mailing address

346 Fort Zumwalt SQ
O Fallon, MO 63366-3065
Phone (636) 978-6400

Other names 1

  • DawnDENTAL Centers Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1700932464",
    "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": {
        "organization_name": "THOMAS D. JORDAN, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "636-978-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DawnDENTAL Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.