Brent Alan Sorenson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4141 Issued in ID

Practice address

BLDG 9900, 2ND Floor
U.S. Army Dental Activity - Fort Lewis
Tacoma, WA 98431-1100

Phone

(253) 968-4039

Fax

(253) 968-5919

NPI assigned

Aug 20, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1023265162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 9900, 2ND FLOOR",
            "address_2": "U.S. ARMY DENTAL ACTIVITY - FORT LEWIS",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-4039",
            "fax_number": "253-968-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 9900, 2ND FLOOR",
            "address_2": "U.S. ARMY DENTAL ACTIVITY - FORT LEWIS",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-4039",
            "fax_number": "253-968-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "BRENT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly J Soran, LMT
• Samuel Charles Sorbello, RN
• Cathy Ann Sorem, RN
• Douglas Melville Sorensen, M.D.
• Jennifer Laura Sorensen, MA
• Maureen K Sorenson
• Michael D Soronen, MD
• Derick Sosa
• Elizabeth Sosa, PSYD
• Joel Sosa

• General Practice Dentistry in Tacoma, WA
• Providers in Tacoma, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.