Pediatric Dental Care

Primary specialty

DentistTaxonomy code 122300000X

License

363178-9923 Issued in UT

Legal business name

PEDIATRIC DENTAL CARE

Doing business as

Bret J Sorensen

Practice address

497 N Main St
Spanish Fork, UT 84660-3002

Phone

(801) 798-2100

Fax

(801) 798-9977

NPI assigned

Sep 8, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Bret J Sorensen, DDS

Title

Owner

Phone

(801) 798-2100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bret J Sorensen Doing business as

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1174070015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 N MAIN ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846603002",
            "telephone_number": "801-798-2100",
            "fax_number": "801-798-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 N MAIN ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846603002",
            "telephone_number": "801-798-2100",
            "fax_number": "801-798-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-798-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "363178-9923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529511826002",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528178604002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bret J Sorensen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyson Parmenter Norton
• Chelsea Michelle Parsons
• Brian Andrew Paulson, PA-C
• Richard D Paxton, M.D.
• Carmen Kahealani Payton
• Penelope Bergeron Counseling
• Sheila M Perez, RN
• Jonah Perkins
• Tangi Perry, BSN
• Rhonda Peters

• Dentist in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.