IndividualActive
Brent Jorgensen
NPI 1275172181 · Orthodontics and Dentofacial Orthopedics Dentistry · Espanola, NM
Provider details
- NPI number
- 1275172181
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- DD4795 (NM)
Specialties & taxonomies
Dental Providers
Practice location
1508 N Riverside Dr
Espanola, NM 87532-2064
Phone: (888) 988-4066
Approximate (ZIP-level) locationGet directions
Mailing address
2050 E Algonquin Rd Ste 610
Schaumburg, IL 60173-4166
Registry dates
- Enumerated
- 2019-12-26
- Last updated
- 2019-12-26
- Certified
- 2019-12-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.