Jordan D Collins, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60223497 Issued in WA

Practice address

8909 Weller Rd SW
Lakewood, WA 98498-5967

Phone

(253) 581-4386

NPI assigned

Jul 1, 2011

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

Enrolled in WA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1720375470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8909 WELLER RD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984985967",
            "telephone_number": "253-581-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8909 WELLER RD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984985967",
            "telephone_number": "253-581-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JORDAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60223497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Sun Cole, COTA/L
• Mona Faye Cole
• Pamela Christine Cole, BA
• Trenton Oliver Coleman, MSW
• Catherine Collins, MSW, LSWAIC
• Tina Marie Collins, LMP
• Roseline Collis
• George Calvin Colon
• Commonspirit Washington
• Community Health Care

• Dentist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.