Jordan Dehko

Primary specialty

Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X

License

82-4958017 Issued in MI

Practice address

26321 Woodward Ave
Huntington Woods, MI 48070-1331

Phone

(248) 882-0794

Fax

(248) 544-7555

NPI assigned

Jun 22, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Level 1 Health Systems of Michigan

  • Physical Therapist
  • Huntington Woods, MI
  • NPI 1174023246
  NPD (past)

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1902391980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26321 WOODWARD AVE",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701331",
            "telephone_number": "248-882-0794",
            "fax_number": "248-544-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26321 WOODWARD AVE",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701331",
            "telephone_number": "248-882-0794",
            "fax_number": "248-544-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHKO",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "MI",
            "license": "82-4958017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CRV Imaging Consultants, Inc.
• Cheryl Dailey
• Daniel a Gross DDS PLLC
• Tori Louise Decaires
• Christine Marie Deeds, MNT
• Stacy Kay Doctoroff, LLPC
• Dustin Palmer Dreese, L.M.T.
• Paul Anthony Dube, LMSW, LISW
• Dubois Counseling and Consulting
• Elise Dubois, LLPC

• Magnetic Resonance Imaging Radiologic Technologist in Huntington Woods, MI
• Providers in Huntington Woods, MI by specialty
• Magnetic Resonance Imaging Radiologic Technologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.