Peter M Jorgenson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9800 Issued in MN

Practice address

1016 1St St S
Willmar, MN 56201-3510

Phone

(320) 235-2010

NPI assigned

Nov 14, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Willmar Family Dentistry, P.a.

  • Dentist
  • Willmar, MN
  • NPI 1205204674
  NPD (past) Authorized official
• Willmar Family Dentistry, PA

  • General Practice Dentistry
  • Willmar, MN
  • NPI 1376615450
  NPD (past) Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205908357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "ANNANDALE",
            "state": "MN",
            "postal_code": "553020337",
            "telephone_number": "320-274-7289"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "PETER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D9800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Johnson, MSW, LICSW
• Tiffany Johnson, LICSW
• Timothy Roger Johnson, MA LMFT
• Mark R Johnston, DPM
• Rachel Michelle Jones, LICSW
• Shealynn Joyce, LPCC
• Richard A Kacher, MD
• William M Kaczrowski, MD
• Elizabeth Marie Kadlec, PHARMD
• Mouna Kahin

• General Practice Dentistry in Willmar, MN
• Providers in Willmar, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.