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EBONY JORDAN DDS
NPI 1891009346
Dentist - Pediatric Dentistry in South Pasadena, CA

Active since July 27, 2010PECOS Enrolled
1427 MISSION ST, SOUTH PASADENA, CA 91030(626) 403-1800 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ebony Jordan Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBONY JORDAN DDS (NPI 1891009346) is an individual pediatric dentistry provider in South Pasadena, California, licensed in California (DDS103462) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891009346
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameEBONY JORDANCredential: DDS
Location Address1427 MISSION STSouth Pasadena, CA 91030-3213
Mailing Address1427 Mission StSouth Pasadena, CA 91030-3213 · (626) 669-4655
Phone(626) 403-1800
Sole ProprietorNo
Enumeration DateJuly 27, 2010
Last NPPES UpdateApril 4, 2024
NPPES CertifiedApril 4, 2024
✔ NPI 1891009346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Licenses✔ Licensed in CA · DDS103462✔ Licensed in IN · 12012022A
Definition
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.
Also ListedDentistTaxonomy 122300000X · License 12012022A (IN)
1427 MISSION ST, South Pasadena, CA 91030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ebony Jordan Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR KIMBERLEY WU PC
Dentist (Pediatric Dentistry)
1427 MISSION ST
SOUTH PASADENA, CA 91030
Los Angeles County (626) 403-6500
DR. KIMBERLEY W WU DMD, MS
Dentist (Orthodontics and Dentofacial Orthopedics)
1427 MISSION ST
SOUTH PASADENA, CA 91030
Los Angeles County (626) 403-1800
PETER STANTON JOE DDS
Dentist (Pediatric Dentistry)
1427 MISSION ST
SOUTH PASADENA, CA 91030
Los Angeles County (626) 403-1800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebony Jordan's NPI number?

The NPI number for Ebony Jordan is 1891009346. It was assigned to this individual provider in the NPPES registry on July 27, 2010.

Where is Ebony Jordan located?

Ebony Jordan practices at 1427 Mission St, South Pasadena, CA 91030. The listed phone number is (626) 403-1800.

What is Ebony Jordan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Ebony Jordan enrolled in Medicare?

Yes. Ebony Jordan is registered in the Medicare PECOS enrollment system.

What insurance does Ebony Jordan accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Cross and Blue Shield of Montana and 6 other insurers list Ebony Jordan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ebony Jordan was last updated on April 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.