Jordan Albert Brunson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013693 Issued in GA

Practice address

501 Park St
Palmetto, GA 30268-1007

Phone

(770) 463-4541

Fax

(770) 463-9184

NPI assigned

Feb 11, 2009

Last updated

Aug 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Dentist

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Palmetto Sleep PC

  • Health Service Clinic/Center
  • McDonough, GA
  • NPI 1679272017
  Medicare reassignment NPD (past) Authorized official
• Palmetto Family Dental, PC

  • General Practice Dentistry
  • Palmetto, GA
  • NPI 1841580560
  NPD (past) Authorized official
• Palmetto Sleep PC

  • Health Service Clinic/Center
  • Palmetto, GA
  • NPI 1891420246
  Authorized official Same address or phone
• Palmetto Sleep, PC

  • Dentist
  • Palmetto, GA
  • NPI 1841121704
  Authorized official Same address or phone

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1861631053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PARK ST",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681007",
            "telephone_number": "770-463-4541",
            "fax_number": "770-463-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PARK ST",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681007",
            "telephone_number": "770-463-4541",
            "fax_number": "770-463-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "JORDAN",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlanta Pharmacy Group, Inc. (Wender & Roberts Drugs - Palmetto)
• Adam Joseph Barefoot, D.M.D.
• Barukh Transportation, LLC
• Carla L Bonner, PHARM.D.
• Tara Brown, D.M.D.
• Shannon Byrd
• Yesenia Carrillo, LCSW
• Clementines Home Healthcare LLC
• Cliniccore
• Naturel Cordova

• General Practice Dentistry in Palmetto, GA
• Providers in Palmetto, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.