Kenneth Robert Sorensen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8340 Issued in MN

Practice address

3475 Plymouth Blvd Ste 100
Plymouth, MN 55447-1497

Phone

(763) 537-1238

Fax

(763) 537-4627

NPI assigned

Mar 23, 2007

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

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.

• Smile Design Dentistry, PLLC

  • General Practice Dentistry
  • Plymouth, MN
  • NPI 1023314564
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750408092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 PLYMOUTH BLVD STE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471497",
            "telephone_number": "763-537-1238",
            "fax_number": "763-537-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 PLYMOUTH BLVD STE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471497",
            "telephone_number": "763-537-1238",
            "fax_number": "763-537-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "KENNETH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Kuperman Sondell, PH.D.
• Sonus- Texas, Inc.
• Sonus-USA, Inc.
• Rachel Sorce, PHARMD
• Brianna Ashley Sorensen
• Soteria Family Health Center
• Soundpoint Audiology
• South Lake Clinic, PA
• Nickolas C Southwick, CRNA
• Kristin Southworth

• General Practice Dentistry in Plymouth, MN
• Providers in Plymouth, 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 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.