MEDICARE: DR. SHARON R JORDAN D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	11473	GA

General Provider Information

NPI Number	:	1306931076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON R JORDAN D.M.D.

Provider Business Mailing Address
First Line	:	540 SAWNEE CORNERS BLVD
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-2056
Country	:	US
Telephone Number	:	770-888-6262
Fax Number	:	678-208-2300

Provider Business Practice Location Address
First Line	:	540 SAWNEE CORNERS BLVD
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-2056
Country	:	US
Telephone Number	:	770-888-6262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/04/2025

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