Provider Demographics
NPI:1649157439
Name:JORDAN M. CALDWELL DDS LLC
Entity type:Organization
Organization Name:JORDAN M. CALDWELL DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:318-450-2941
Mailing Address - Street 1:416 COPPER FLDS
Mailing Address - Street 2:
Mailing Address - City:STERLINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:71280-3534
Mailing Address - Country:US
Mailing Address - Phone:318-450-2941
Mailing Address - Fax:
Practice Address - Street 1:2018 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-4035
Practice Address - Country:US
Practice Address - Phone:318-814-8136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental