Ben Cooper Jorgensen, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

09095 Issued in IA

Practice address

550 Pond View Dr Ste 2
North Liberty, IA 52317

Phone

(319) 459-1975

Fax

(319) 459-1977

NPI assigned

Sep 25, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Corridor Endodontics PC

  • Dental Clinic/Center
  • North Liberty, IA
  • NPI 1326454042
  NPD (past) Authorized official
• Corridor Endodontics LLC

  • Endodontics
  • North Liberty, IA
  • NPI 1033724679
  NPD (past)

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1649521121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DENTAL SCIENCE S",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-384-1139",
            "fax_number": "319-384-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POND VIEW DR STE 2",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "52317",
            "telephone_number": "319-459-1975",
            "fax_number": "319-459-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "BEN",
        "middle_name": "COOPER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "09095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LHI",
            "identifier": "1649521121",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa R Johnson, M.D.
• Chloe Jones
• Claire Elizabeth Jones
• Daniel L Jones, M.D.
• Damon M Jordan, PA-C
• Journey Counseling Services LLC
• Miranda M Juarez, LMSW
• Tess M Judge-Ellis, DND, ARNP
• Stacie Ann Kasper
• Kay Family Chiropractic, PLLC

• Endodontics in North Liberty, IA
• Providers in North Liberty, IA by specialty
• Endodontics in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.