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Contact Information

AMANDA JORGENSEN, DDS
100 SW BROOKSIDE DR
GRIMES, IA50111
 Phone: 515-986-3926
 Fax: 515-986-5116
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for AMANDA JORGENSEN · (Female)

NPI # 1235158452
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/19/2006
Last updated 04/26/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • IA License # 08223
  • IA Medicaid 0293605
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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