Jerold R Sorensen DDS a Professional Corporation

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

20944 Issued in CA

Legal business name

JEROLD R SORENSEN DDS A PROFESSIONAL CORPORATION

Practice address

90 W 500 S
Heber City, UT 84032

Phone

(435) 654-1413

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerry R. Sorensen, DDS

Title

Pres

Phone

(559) 447-0544

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerold R. Sorensen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Heber City, UT
  • NPI 1528286226
  NPD
• Jason Sorensen, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fresno, CA
  • NPI 1134346844
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1770701476",
    "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": [
        {
            "address_1": "1480 W Herndon Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937110552",
            "country_code": "US",
            "telephone_number": "559-447-0544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEROLD R SORENSEN DDS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "559-447-0544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "20944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL#",
            "identifier": "B2094403",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer Jacobson, DMD
• Jared R Brown DMD Ms PC
• Kelly B Jarvis Sr., D.C.
• Abigail Lauren Jenkins, PH.D.
• Estefanya Yuritza Jenson
• Matthew M Jimenez, ACMHC
• Annette Isom Johnson, CNM
• Cameron W Johnson, PHARMD
• Enjolei Johnson
• Janell L Jones, CMHC

• 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 Oct 24, 2019; 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.