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NPI Code Detail

MEDICARE: DR. JANA SORENSEN DDS

MEDICARE:  DR. JANA  SORENSEN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD14208MN

General Provider Information

NPI Number : 1689231011
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANA SORENSEN DDS
Provider Business Mailing Address
First Line : 6313 LYNN WAY
Second Line :
City : WOODBURY
State : MN
Zip : 55129-9544
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3359 W BROADWAY AVE
Second Line :
City : ROBBINSDALE
State : MN
Zip : 55422-2928
Country : US
Telephone Number : 763-270-5776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2019
Last Update Date : 05/21/2019

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Directions to “ DR. JANA SORENSEN DDS” Practice Location

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