Jennifer Lin Sorge, DDS
Individual provider Active NPI General Practice Dentistry · Vineyard, UT
NPI 1750992111 · NPPES record last updated Aug 11, 2020
Key facts
- NPI
- 1750992111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 11778108-9922 (UT)
- Practice address
- 532 N Mallard Dr Unit a
Vineyard, UT 84059-6606 - Phone
- (210) 213-8685
- NPI assigned
- Aug 11, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11778108-9922 | UT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11778108-9922 | UT | Yes |
Addresses
Primary practice location
532 N Mallard Dr Unit a
Vineyard, UT 84059-6606
Mailing address
532 N Mallard Dr Unit a
Vineyard, UT 84059-6606
Phone (210) 213-8685
Other providers in Vineyard, UT
- Premier Family Medical - Vineyard
- Ian Kyle Rader
- Hilma Karen Rodriguez
- Shruti B. Sanghvi
- Tom Sitake
- Southwest Spine and Pain Care Specialists, LLC
- Leah Stratton
- Ryan Thomas Sudweeks
- Conner Donald Sugrue
- Heather Taylor
All providers in Vineyard, UT · General Practice Dentistry in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.