Jack D Jorgensen DMD PS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DE00009473 Issued in WA

Legal business name

JACK D JORGENSEN DMD PS

Practice address

7107 NE Vancouver Mall Dr
Ste. #D
Vancouver, WA 98661-8178

Phone

(360) 892-6555

Fax

(360) 892-4170

NPI assigned

Sep 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jack Denzil Jorgensen, DMD

Title

President

Phone

(360) 892-6555

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dental Concepts Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Advanced Dental Sleep Solutions LLC

  • Durable Medical Equipment & Medical Supplies
  • Vancouver, WA
  • NPI 1730625302
  NPPES parent name

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053413591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7107 NE VANCOUVER MALL DR",
            "address_2": "STE. #D",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986618178",
            "telephone_number": "360-892-6555",
            "fax_number": "360-892-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7107 NE VANCOUVER MALL DR",
            "address_2": "STE. #D",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986618178",
            "telephone_number": "360-892-6555",
            "fax_number": "360-892-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK D JORGENSEN DMD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORGENSEN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "DENZIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-892-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00009473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Concepts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• J. Blake Perkins, DDS, PS
• J. Hollar, DMD, PLLC
• J.Blake Perkins D.D.S. P.S.
• J&D Health, PLLC
• Debra Beth Jablonski, SLP
• Alexandra M Jack, RD
• Lauren Jackle
• James M Jackman, DO
• Brenda Lee Jacks, RPH
• Shalie Jackson-Dahrens

• Dental Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.