# WISDOM TOOTH PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194679704
- **Authorized official:** CODY JOHN JORDAN DDS (ORAL SURGEON)
- **Authorized official phone:** (701) 699-6966

## Contact information

- **Practice address:** 5675 26TH AVE S STE 116, FARGO, ND 58104-8599
- **Practice address phone:** (701) 699-6966
- **Practice address fax:** (701) 929-5441
- **Mailing address:** 5675 26TH AVE S STE 116, FARGO, ND 58104-8599
- **Mailing address phone:** (701) 699-6966
- **Mailing address fax:** (701) 929-5441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2026
- **Last updated:** 02/23/2026