TERESA DANIELLE JORDAN DMD NPI 1780888693

NPI Information

  • NPI: 1780888693
  • Provider Name: TERESA DANIELLE JORDAN, DMD
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • Address: 2646 GRESHAM RD SE
    ATLANTA, GA
    ZIP 30316
  • Phone: (404) 212-9060

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NPI Details

Teresa Danielle Jordan, DMD is a pediatric dentistry dentist in Atlanta, GA. The provider is 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. Teresa Danielle Jordan, DMD NPI is 1780888693. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2646 GRESHAM RD SE
ATLANTA, GA
ZIP 30316-148
Phone: (404) 212-9060
Fax: (404) 212-9020

The enumeration date for this NPI number is 6/13/2007 and was last updated on 2/20/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric DentistryDN012645GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1108964405MEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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