Individual provider Active NPI

Scharie T Jordan, DMD

  • Dentist
  • Dorado, PR
National Provider Identifier
1912090705
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
LIC #2189 Issued in PR
Practice address
Marginal Costa de Oro C3
Suite 12
Dorado, PR 00646
Phone
(787) 796-7301
Fax
(787) 796-9672
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X LIC #2189 PR Primary

Addresses

Primary practice location

Marginal Costa de Oro C3
Suite 12
Dorado, PR 00646

Mailing address

PO Box 1029
Dorado, PR 00646-1029
Phone (787) 796-7301

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

LicenseStateTypeSpecialty
LIC #2189PRMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
DDFP LLC General Practice PastSince Apr 14, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912090705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006461029",
            "telephone_number": "787-796-7301",
            "fax_number": "787-796-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARGINAL COSTA DE ORO C3",
            "address_2": "SUITE 12",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-796-7301",
            "fax_number": "787-796-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SCHARIE",
        "middle_name": "T",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "LIC #2189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.