Emily Rebecca Jordan, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

30-022492 Issued in OH

Practice address

652 West Central Ave
Suite 80
Delaware, OH 43015

Phone

(740) 369-4550

Fax

(740) 363-3546

NPI assigned

Sep 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Emily Rebecca Tolley Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1740476472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 WEST CENTRAL AVE",
            "address_2": "SUITE 80",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "43015",
            "telephone_number": "740-369-4550",
            "fax_number": "740-363-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 WEST CENTRAL AVE",
            "address_2": "SUITE 80",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "43015",
            "telephone_number": "740-369-4550",
            "fax_number": "740-363-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "EMILY",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OH",
            "license": "30022492",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OH",
            "license": "30-022492",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-022492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "TOLLEY",
            "middle_name": "REBECCA",
            "credential": "DDS, MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Jeffrey, APRN/CNP
• James Elisha Jenkins, PH.D., P.T.
• Aidan Johnson, LMFT
• Sara Elizabeth Jones, CAREGIVER
• Sarah Jane Jones, CNP
• Dany Jose, DMD
• Jonathan Journay, D.M.D.
• Journey Together LLC
• Judith K Held MD Inc
• David Philip Kallile, M.D.

• Dentist in Delaware, OH
• Providers in Delaware, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.