NPIMap

Organization Active NPI

Jordan Dental /Self

  • Dental Clinic/Center
  • Merna, NE
National Provider Identifier
1831759885
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
JORDAN DENTAL /SELF
Doing business as
Jordan Dental /self
Practice address
130 W Old Highway 2
Merna, NE 68856-5627
Phone
(308) 870-3967
NPI assigned
Jun 20, 2019
Last updated
Jun 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Authorized official

Name
Dr. Clint JordanNPI 1215260286
Title
Dentist
Phone
(308) 870-3967

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
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

130 W Old Highway 2
Merna, NE 68856-5627

Mailing address

130 W Old Highway 2
Merna, NE 68856-5627
Phone (308) 870-3967

Other names 1

  • Jordan Dental /self Doing business as

National Provider Directory

National Provider Directory

Locations

130 W Old Highway 2
Merna, NE 68856
Phone (308) 643-2255

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1831759885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W OLD HIGHWAY 2",
            "city": "MERNA",
            "state": "NE",
            "postal_code": "688565627",
            "telephone_number": "308-870-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W OLD HIGHWAY 2",
            "city": "MERNA",
            "state": "NE",
            "postal_code": "688565627",
            "telephone_number": "308-870-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN DENTAL /SELF",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "308-870-3967",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jordan Dental /self",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merna, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.