Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRENT LEE JORGENSEN
Active Sole ProprietorBRENT LEE JORGENSEN is a Orthodontics healthcare provider located in ESPANOLA, New Mexico. NPI 1275172181 is currently active in the NPPES registry. Verify at CMS.
Orthodontics · ESPANOLA, NM
Registration Details
- NPI Number
- 1275172181
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 26, 2019 (6.6420640299122 yrs)
- Last Updated
- Dec 26, 2019
- License
-
DD4795 (NM)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1508 N RIVERSIDE DRESPANOLA, NM, 875322064Browse NM providers · Browse ZIP 87532
- Phone
- 8889884066
- Primary Specialty
-
Orthodontics
1223X0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.