Clinton Oliver Sorensen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27343 Issued in TX

Practice address

2725 E Parleys Way Ste 150
Salt Lake City, UT 84109-1659

Phone

(801) 808-2061

NPI assigned

Oct 17, 2011

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

Medicare enrollment (NPD)

Not 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.

• Nexus Dental Group PLLC

  • Dental Clinic/Center
  • Salt Lake City, UT
  • NPI 1013416742
  NPD (past) Authorized official

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1760767230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 E ROYCROFT PL APT A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242588",
            "telephone_number": "801-808-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 E PARLEYS WAY STE 150",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091659",
            "telephone_number": "801-808-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "CLINTON",
        "middle_name": "OLIVER",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "80174279922",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallorie Sorce
• Jennifer Marie Sorensen Whitaker, CD (DONA)
• Ashley Sorensen
• Ashley Nicole Sorensen
• Braxton Sorensen
• Darren L Sorensen, FNP
• Jennifer C Sorensen, CNM
• Kimberly Sorensen
• Kristina Kay Sorensen
• Lisa Sorensen

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.