Corsicana Hometown Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CORSICANA HOMETOWN DENTAL

Practice address

416 N 15TH St
Corsicana, TX 75110-4514

Phone

(903) 872-7388

Fax

(903) 872-6896

NPI assigned

Mar 5, 2025

Last updated

Mar 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jorden Mark Mortensen, DMDNPI 1962069369

Title

Owner

Phone

(512) 520-6365

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jorden Mark Mortensen, DMD

  • General Practice Dentistry
  • Kingwood, TX
  • NPI 1962069369
  Authorized official Same address or phone
• Pete Robert McElroy, DDS

  • General Practice Dentistry
  • Corsicana, TX
  • NPI 1831264183
  NPD (past)

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1861290884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N 15TH ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751104514",
            "telephone_number": "903-872-7388",
            "fax_number": "903-872-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N 15TH ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751104514",
            "telephone_number": "903-872-7388",
            "fax_number": "903-872-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORSICANA HOMETOWN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "MORTENSEN",
        "authorized_official_first_name": "JORDEN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-520-6365",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corsicana Childrens Dental Associates
• Corsicana Chiropractic, LLC
• Corsicana Envision Eyecare PA
• Corsicana First Eyecare PLLC
• Corsicana Health Care LLC (Country Meadows Nursing and Rehabilitation Center)
• Corsicana II Enterprises, L.L.C. (Legacy at Corsicana Rehabilitation and Healthcare)
• Corsicana III Enterprises, L.L.C. (The Village at Heritage Oaks)
• Corsicana Isd
• Corsicana IV Enterprises, L.L.C. (The Village at Heritage Oaks Assisted Living)
• Corsicana Pediatric Dentistry, PA (Corsicana Pediatric Dentistry)

• General Practice Dentistry in Corsicana, TX
• Providers in Corsicana, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.