Active NPI
Willmar Family Dentistry, P.a.
- Dentist
- Willmar, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9800
- Legal business name
- WILLMAR FAMILY DENTISTRY, P.A.
- Practice address
- 1016 1St St S
Willmar, MN 56201-3510 - Phone
- (320) 235-2010
- Fax
- (320) 235-7133
- NPI assigned
- Sep 2, 2015
- Last updated
- Sep 2, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Peter Jorgenson, D.D.S.
- Title
- Dentist
- Phone
- (320) 235-2010
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9800 | MN | Primary |
| Dental Therapist | 125J00000X | DT54 | MN |
Addresses
Primary practice location
1016 1St St S
Willmar, MN 56201-3510
Mailing address
1016 1St St S
Willmar, MN 56201-3510
Phone (320) 235-2010
National Provider Directory
National Provider Directory- Tax ID family
- Willmar Family Dentistry PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Willmar, MN
- NPI 1376615450
Locations
1016 1st St S
Willmar, MN 56201
Phone (320) 235-2010
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Willmar, MN
- NPI 1205908357
-
- Dental Therapist
- Willmar, MN
- NPI 1538633946
-
- General Practice Dentistry
- Willmar, MN
- NPI 1689171282
-
- Dental Therapist
- Bloomington, MN
- NPI 1982148227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1441152000000",
"number": "1205204674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 1ST ST S",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013510",
"telephone_number": "320-235-2010",
"fax_number": "320-235-7133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 1ST ST S",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013510",
"telephone_number": "320-235-2010",
"fax_number": "320-235-7133"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLMAR FAMILY DENTISTRY, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2015-09-02",
"last_updated": "2015-09-02",
"status": "A",
"authorized_official_last_name": "JORGENSON",
"authorized_official_first_name": "PETER",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "320-235-2010",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "9800",
"primary": true
},
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DT54",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willmar, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.