Active NPI
Michael Eugene Jordan Jr., DMD
- Dentist
- Hixson, TN
National Provider Identifier
1740902006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12025
- Practice address
- 5550 Highway 153 Ste 100
Hixson, TN 37343-4991 - Phone
- (423) 875-2626
- NPI assigned
- Sep 14, 2022
- Last updated
- Sep 14, 2022
- 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 | 12025 | TN | Primary |
Addresses
Primary practice location
5550 Highway 153 Ste 100
Hixson, TN 37343-4991
Mailing address
5081 City Station Dr Apt 201
Ooltewah, TN 37363-7080
Phone (919) 333-2258
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A & Z Dental, PC | Dentist | Past | Accepting new patients |
| Aeb Dental PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Hixson, TN
- NPI 1790252211
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1740902006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5081 CITY STATION DR APT 201",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373637080",
"telephone_number": "919-333-2258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5550 HIGHWAY 153 STE 100",
"city": "HIXSON",
"state": "TN",
"postal_code": "373434991",
"telephone_number": "423-875-2626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "MICHAEL",
"middle_name": "EUGENE",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "12025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.