TERESA DANIELLE JORDAN (NPI# 1780888693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780888693 |
| Entity Type | Individual |
| Full Name | TERESA DANIELLE JORDAN |
| Credential | DMD |
| Practice Address |
2646 Gresham Rd Se Atlanta GA 30316-4148 |
| Mailing Address |
150 Milano Dr Sw Atlanta GA 30331-8381 |
| Practice Telephone | 4042129060 |
| Practice Fax Number | 4042129020 |
| Mailing Telephone | 7704490836 |
| Mailing Fax Number | 7704410299 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2017-02-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN012645 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 108964405 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114225505 | Teresa Freeman Jordan | Pharmacist | 1200 Benns Church Blvd, Smithfield, VA 23430-6063 | 2011-03-08 |
| 1972727808 | Teresa D. Jordan | Registered Nurse | 927 E Baddour Pkwy, Lebanon, TN 37087-3706 | 2007-04-12 |
| 1134215106 | Teresa Jordan | Counselor | 400 S Broadway St, Burlington, IA 52601-9407 | 2006-10-05 |
| 1912015272 | Teresa J Jordan | Physician Assistant | 800 West Ave S, La Crosse, WI 54601 | 2006-08-28 |
| Street Address |
2646 GRESHAM RD SE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30316-4148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740688142 | East Atlanta Pediatric Dentistry PC | Dentist | 2646 Gresham Rd Se, Atlanta, GA 30316-4148 | 2014-12-17 |
| 1548302920 | Gideon K Mincey | Optometrist | 2646 Gresham Rd Se, Atlanta, GA 30316-4148 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156923 | Rakiya Williams | Counselor | 1030 Fayetteville Rd., Atlanta, GA 30316 | 2019-10-23 |
| 1215585815 | Madison Victoria Baugh | Counselor | Chris180, 1030 Fayetteville Rd, Atlanta, GA 30316 | 2019-08-28 |
| 1265089460 | Josee Dominque Muldrew | Counselor | 1030 Fayetteville Rd. Se, Atlanta, GA 30316 | 2019-08-22 |
| 1255984241 | Monique Overstreet | Counselor | 1030 Fayetteville Road, Atlanta, GA 30316 | 2019-07-19 |
| 1023573979 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 905 Memorial Drive Se, Atlanta-fulton, GA 30316 | 2019-02-05 |
| 1740726454 | Jimmy Brian Sambula | Behavior Technician | 1017 Fayetteville Rd. Se, Atlanta, GA 30316 | 2017-01-19 |
| 1033665039 | Liberty Group Senior Services | Clinic/Center | 1879 Glenwood Avenue, Atlanta, GA 30316 | 2016-08-30 |
| 1043673650 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 800 Glenwood Ave Se, Atlanta, GA 30316 | 2016-03-31 |
| 1992143382 | Ayodele Osasona | Surgery | 2004 Oak Terrace Dr Se, Atlanta, GA 30316 | 2013-06-07 |
| 1891945721 | Denise Renee Cagle | Social Worker | 1471 Town Country Dr Se, Atlanta, GA 30316 | 2008-09-28 |
| Find all providers in zip 30316 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629619200 | Peachtree Hills Pediatric Dentistry | Dentist | 2385 Peachtree Rd Ne Ste A2ab, Atlanta, GA 30305-4139 | 2019-10-04 |
| 1952969396 | Ns3 Services, LLC | Dentist | 1039 Grant St Se Ste B11, Atlanta, GA 30315-2050 | 2019-05-31 |
| 1215336326 | Esther Lee | Dentist | 270 17th St Nw Unit 1706, Atlanta, GA 30363-1248 | 2014-08-14 |
| 1679993430 | Nikky Shotwell | Dentist | 2979 Silver Hill Ter., S.e., Atlanta, GA 30316-6715 | 2014-04-21 |
| 1932528577 | Jaha V Howard Dds LLC | Dentist | 4300 Paces Ferry Rd Se Ste 405, Atlanta, GA 30339-5759 | 2014-04-10 |
| 1790086668 | Dentistry for Children of Georgia LLC | Dentist | 1350 Spring St Nw Ste 600, Atlanta, GA 30309-2870 | 2010-11-09 |
| 1003123563 | Perimeter Pediatric Dentistry PC | Dentist | 2221 Johnson Ferry Rd Ne, Ste 2-a, Atlanta, GA 30319-2203 | 2010-09-07 |
| 1497905681 | David Michael Treff | Dentist | 4536 Chamblee Dunwoody Rd Ste 211, Atlanta, GA 30338-6201 | 2008-09-24 |
| 1659413953 | Ezat Mulki | Dentist | 1350 Spring St Nw, Ste 600, Atlanta, GA 30309-2864 | 2007-02-13 |
| 1598803868 | Mitchell D. Vaughan | Dentist | 1150 Lake Hearn Dr Ste 170, Atlanta, GA 30342-1568 | 2007-02-01 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.