Jerold R. Sorensen, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

20944 Issued in CA

Practice address

90 W 500 S
Heber City, UT 84032

Phone

(435) 654-1413

NPI assigned

Apr 20, 2007

Last updated

Aug 4, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Jerold R Sorensen DDS a Professional Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Heber City, UT
  • NPI 1770701476
  NPD
• Jason Sorensen D.D.S. a Professional Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Fresno, CA
  • NPI 1952528671
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1528286226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 W 500 S",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "84032",
            "telephone_number": "435-654-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W 500 S",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "84032",
            "telephone_number": "435-654-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "JEROLD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "20944",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "132252-9924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah E Skolout, N.D.
• Cameryn Leigh Smith, APRN
• Tamatha Lee Smith, CMHC
• Smiths Food & Drug Centers Inc (Smiths Pharmacy #63)
• Solstice Counseling & Wellness
• John B Sorensen, MD
• Ben Springer, PH.D.
• Daniel Stagg, P.T.
• Stanton McDonald, MD PC
• Stillwater Psychology, LLC

• Oral and Maxillofacial Surgery (Dentist) in Heber City, UT
• Providers in Heber City, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.