Jeffrey L Sorensen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WI3640 Issued in WI

Practice address

24418 75TH St
Salem, WI 53168-9703

Phone

(262) 843-2004

Fax

(262) 843-2832

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

Yes

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.

• Jeffrey L Sorensen DDS

  • General Practice Dentistry
  • Salem, WI
  • NPI 1740406396

  General Practice

  NPD (past)
• Lifetime Dental Care of Wisconsin, S.C.

  • General Practice Dentistry
  • Salem, WI
  • NPI 1558975177

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972648459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24418 75TH ST",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531689703",
            "telephone_number": "262-843-2004",
            "fax_number": "262-843-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24418 75TH ST",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531689703",
            "telephone_number": "262-843-2004",
            "fax_number": "262-843-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "WI3640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Smart, DPT
• Smith Chiropractic Office S.C.
• Bradley J. Smith, D.C.
• Jocelyn Smith, RD, CD
• SNF Care Inc
• Sports Physical Therapy & Rehab Specialist SC
• Stateline Midwives, LLC
• Ashley Swan, NP
• Jennifer Takata, D.O.
• Turning Leaf Acupuncture, LLC

• All providers in Salem, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.