Justin Harold Sorenson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12011688A Issued in IN

Practice address

513 E Lewis and Clark Pkwy
Clarksville, IN 47129-1729

Phone

(502) 935-0505

Fax

(484) 842-7509

NPI assigned

Jun 28, 2011

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CDP LLC

  dba Clarksville Dental Care

  • General Practice Dentistry
  • Clarksville, IN
  • NPI 1891085775
  NPD Authorized official

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1871889857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 E LEWIS AND CLARK PKWY",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471291729",
            "telephone_number": "502-935-0505",
            "fax_number": "484-842-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 E LEWIS AND CLARK PKWY",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471291729",
            "telephone_number": "502-935-0505",
            "fax_number": "484-842-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "JUSTIN",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011688A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Katherine Snyder, R.PH.
• Sadie E Soliday, RBT
• Sumit Som, M.D.
• Audrey Sonne
• Katlin Sorells
• Richard M Spalding, M.D.
• Steven W Spalding
• Carly Rose Sperzel, DNP, APRN
• Kojo Spio
• Carl Stanis, OD

• General Practice Dentistry in Clarksville, IN
• Providers in Clarksville, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.