Individual provider Active NPI

Jordan Michael Ferrage, D.D.S.

  • General Practice Dentistry
  • Statesville, NC
National Provider Identifier
1952687865
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12606 Issued in NC
Practice address
1207 Davie Ave
Statesville, NC 28677-3511
Phone
(704) 873-4271
NPI assigned
Oct 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12606 NC Primary

Addresses

Primary practice location

1207 Davie Ave
Statesville, NC 28677-3511

Mailing address

1207 Davie Ave
Statesville, NC 28677-3511
Phone (704) 873-4271

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
12606NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda B Kotis, DMD, PA General Practice CurrentSince Dec 7, 2025 Accepting new patients
Londry & Modlin X DDS PLLC General Practice CurrentSince Dec 7, 2025 Accepting new patients

Locations

1207 Davie Ave
Statesville, NC 28677
Phone (704) 873-4271

Organizations & group practices 2

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": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1952687865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773511",
            "telephone_number": "704-873-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773511",
            "telephone_number": "704-873-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRAGE",
        "first_name": "JORDAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-25",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.