Ronald Allen Jurgensen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DG29316 Issued in CA

Practice address

307 Placentia Ave
201
Newport Beach, CA 92663-3308

Phone

(949) 646-4868

Fax

(949) 631-1645

NPI assigned

Oct 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164507968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 PLACENTIA AVE",
            "address_2": "201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633308",
            "telephone_number": "949-646-4868",
            "fax_number": "949-631-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 PLACENTIA AVE",
            "address_2": "201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633308",
            "telephone_number": "949-646-4868",
            "fax_number": "949-631-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURGENSEN",
        "first_name": "RONALD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DG29316",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "35063",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.