JASON SORENSEN D.D.S. A PROFESSIONAL CORPORATION (NPI# 1952528671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952528671 |
| Entity Type | Organization |
| Organization Name | JASON SORENSEN D.D.S. A PROFESSIONAL CORPORATION |
| Practice Address |
1480 W Herndon Ave Fresno CA 93711-0552 |
| Practice Telephone | 5594470544 |
| Practice Fax Number | 5594311827 |
| Mailing Telephone | 5594470544 |
| Mailing Fax Number | 5594311827 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2009-12-08 |
| Authorized Official Name | DR. JASON SORENSEN (PRESIDENT) |
| Authorized Official Telephone | 5594470544 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
46690 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTI-CAL PROVIDER ID | G9286601 | 01 |
| Street Address |
1480 W HERNDON AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-0552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134346844 | Jason Sorensen | Dentist | 1480 W Herndon Ave, Fresno, CA 93711-0552 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104464684 | Kazi Shafiul Moula | Dentist | Western Dental/ Brident 150bfo, 3077 W Shaw Ave, Fresno, CA 93711 | 2019-12-16 |
| 1760037063 | Armine Petrosyan | Nurse Practitioner | 427 W Beford Ave Suite 103, Fresno, CA 93711 | 2019-08-05 |
| 1912489360 | Shoua Nelson | Nurse Practitioner | 2490 W. Shaw Avenue Suite 101, Fresno, CA 93711 | 2018-09-02 |
| 1245725506 | Promesa Behavioral Health-barstow | Community Based Residential Treatment Facility, Mental Illness | 1415 W Barstow Ave, Fresno, CA 93711 | 2018-06-28 |
| 1407344138 | Aidan Mechem | Behavior Technician | 5140 N. Fruit Avene, Fresno, CA 93711 | 2018-04-27 |
| 1841798840 | Michael Ramos IIi | Behavior Technician | 1690 N Shaw Ave, 102, Fresno, CA 93711 | 2018-01-25 |
| 1962913467 | Dhara Devendrakumar Patel | Pharmacist | 740 West Alluvial Avenue, Suite 101, Fresno, CA 93711 | 2017-10-24 |
| 1588183636 | Bianca Arteaga | Counselor | 7485 N. Palm Ave., Suite 103, Fresno, CA 93711 | 2017-09-10 |
| 1346763158 | Powell Pediatric Dentistry Ingram Partnership | Dentist | 7761 N Ingram Ave, Suite 101, Fresno, CA 93711 | 2017-07-24 |
| 1982124202 | Justine Syera Balbas | Counselor | 2766 W. Celeste Ave., Unit 103, Fresno, CA 93711 | 2017-06-27 |
| Find all providers in zip 93711 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| 1306212428 | Robin Lynn Reisz | Dentist | 1105 E Spruce Ave Ste 204, Fresno, CA 93720-3313 | 2015-08-12 |
| 1396155875 | Phillip Austin Harrison | Dentist | 1195 W San Ramon Ave, Fresno, CA 93711-3152 | 2014-05-05 |
| 1417390253 | Brian K Huh | Dentist | 1903 E Fir Ave Ste 101, Fresno, CA 93720-3862 | 2013-04-11 |
| 1164688396 | Shabaz Sandhu | Dentist | 498 W Bluff Ave, Fresno, CA 93711-6928 | 2008-08-07 |
| 1962699777 | Scott J. Fimbres, D.d.s., Inc. | Dentist | 7585 N Colonial Ave Ste 105, Fresno, CA 93711 | 2007-09-26 |
| 1508938523 | Center for Corrective Jaw & Facial Surgery .... | Dentist | 7055 N Fresno St #202, Fresno, CA 93720 | 2006-11-14 |
| 1831282755 | David Russell Adams | Dentist | 1111 E Herndon Ave Ste 119, Fresno, CA 93720-3100 | 2006-10-02 |
| 1144257619 | Gerald Wayne Alexander | Dentist | 7585 N Colonial Ave, Ste 105, Fresno, CA 93711-5889 | 2006-06-28 |
| 1023505237 | Andrew R. Rahn, Dds, PC | Dentist | 1313 E Herndon Ave Ste 104, Fresno, CA 93720 | 2018-04-13 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.