Richard L. Jorgensen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

NY028535DDS Issued in NY

Practice address

The Eaton Center
24 Conkey Avenue, Suite 300
Norwich, NY 13815

Phone

(607) 336-5858

Fax

(607) 334-6821

NPI assigned

May 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528270394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE EATON CENTER",
            "address_2": "24 CONKEY AVENUE, SUITE 300",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "13815",
            "telephone_number": "607-336-5858",
            "fax_number": "607-334-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE EATON CENTER",
            "address_2": "24 CONKEY AVENUE, SUITE 300",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "13815",
            "telephone_number": "607-336-5858",
            "fax_number": "607-334-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "RICHARD",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "NY028535DDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Lyons Jeffery, LMHC
• Jeffrey a Todd Patricia Lynn Warski DPMS PLLC
• Ronald I Jensen, RPA
• Colette Johnson, PA
• Lisa Ann Jones, R.N.
• Gerald A Kabat, LMSW
• Jamal K Kacyrat, MD
• Tabitha Ann Kampe, RN
• Breanna Kappauf, RN
• Nellene Alaine Kappaus, LPN

• General Practice Dentistry in Norwich, NY
• Providers in Norwich, NY by specialty
• General Practice Dentistry in New York

• 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.