John N Ordahl Sr., D.D.S.M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

5462 Issued in CO

Practice address

3505 Austin Bluffs Pkwy Suiet 215
Colorado Springs, CO 80918

Phone

(719) 596-3098

Fax

(719) 596-3009

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• John N. Ordahl DDS Ms

  • Dental Clinic/Center
  • Colorado Springs, CO
  • NPI 1801027925
  NPD Authorized official

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1851377014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 AUSTIN BLUFFS PKWY SUIET 215",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80918",
            "telephone_number": "719-596-3098",
            "fax_number": "719-596-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 AUSTIN BLUFFS PKWY SUIET 215",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80918",
            "telephone_number": "719-596-3098",
            "fax_number": "719-596-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDAHL",
        "first_name": "JOHN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.D.S.M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "5462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA DMO",
            "identifier": "0005233146",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "794996",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801027925",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02054625",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.