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DR. JORDAN PELLEGROM D.D.S.
NPI 1639806326
Dentist - Pediatric Dentistry in Sartell, MN

Active since August 03, 2022
140 TWIN RIVERS CT, SARTELL, MN 56377(320) 257-3380 Get Directions Write a Review

NPPES record last updated: September 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 5, 2023, Aug 3, 2022 (2 updates tracked since 2022).

About Dr. Jordan Pellegrom D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JORDAN PELLEGROM D.D.S. (NPI 1639806326) is an individual pediatric dentistry provider in Sartell, Minnesota, licensed in Minnesota (D14853) and active in the NPI registry since August 2022.

NPPES Registry Identity

NPI1639806326
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. JORDAN PELLEGROMCredential: D.D.S.
Location Address140 TWIN RIVERS CTSartell, MN 56377-2015
Mailing Address11757 E 25th Ave Unit 7208Aurora, CO 80010-1297 · (320) 223-4237
Phone(320) 257-3380
Sole ProprietorNo
Enumeration DateAugust 3, 2022
Last NPPES UpdateSeptember 5, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2023
✔ NPI 1639806326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MN · D14853
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
140 TWIN RIVERS CT, Sartell, MN 56377
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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KATHRYN ELIZABETH THOMPSON DDS
Dentist (Pediatric Dentistry)
140 TWIN RIVERS CT
SARTELL, MN 56377
Stearns County (320) 257-3380
DR. DENNIS CARRERAS D.M.D.
Dentist (Pediatric Dentistry)
140 TWIN RIVERS CT
SARTELL, MN 56377
Stearns County (320) 257-3380
DENTISTRY FOR CHILDREN, P.A.
Dentist (Pediatric Dentistry)
140 TWIN RIVERS CT
SARTELL, MN 56377
Stearns County (320) 257-3380
DR. KYLE KNUDSEN D.D.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
140 TWIN RIVERS CT
SARTELL, MN 56377
Stearns County (320) 255-1111
DR. MITCHELL ANDREW LOEB D.D.S.
Dentist
140 TWIN RIVERS CT
SARTELL, MN 56377
Stearns County (913) 620-2958
DR. MITCHELL W KRAMER D.D.S.
Dentist (Pediatric Dentistry)
140 TWIN RIVERS CT
SARTELL, MN 56377
Stearns County (320) 257-3380

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Pellegrom's NPI number?

The NPI number for Jordan Pellegrom is 1639806326. It was assigned to this individual provider in the NPPES registry on August 3, 2022.

Where is Jordan Pellegrom located?

Jordan Pellegrom practices at 140 Twin Rivers Ct, Sartell, MN 56377. The listed phone number is (320) 257-3380.

What is Jordan Pellegrom's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Jordan Pellegrom was last updated on September 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.