Active NPI
La Tonya Jordan, DDS
- Dentist
- Houston, TX
National Provider Identifier
1801925920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22482
- Practice address
- 2002 Holcombe Blvd
Mailcode 580/160
Houston, TX 77030-4211 - Phone
- (713) 791-1414
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22482 | TX | Primary |
| Dentist | 122300000X | 2002001254 | MO |
Addresses
Primary practice location
2002 Holcombe Blvd
Mailcode 580/160
Houston, TX 77030-4211
Mailing address
2002 Holcombe Blvd
Mailcode 580/160
Houston, TX 77030-4211
Phone (713) 791-1414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175796502 | Medicaid | TX |
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 |
|---|---|---|---|
| 22482 | TX | MD | Clinical Psychologist |
| 2002001254 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395705600000",
"number": "1801925920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"address_2": "MAILCODE 580/160",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304211",
"telephone_number": "713-791-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"address_2": "MAILCODE 580/160",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304211",
"telephone_number": "713-791-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "LA TONYA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2014-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "22482",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2002001254",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "175796502",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.