Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jordan Pellegrom, DDS

Individual provider Pediatric Dentistry · NPI 1639806326

Dr. Jordan Pellegrom, DDS is a Pediatric Dentistry in Sartell, Minnesota. Licensed in Minnesota. Registered with an NPI since 2022.

Licensed in
MN
In the registry since
2022
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

140 Twin Rivers Ct
Sartell, MN 56377-2015
Phone: (320) 257-3380
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence D14853 (MN)

Record details

NPI number1639806326
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedAugust 3, 2022
Last updated in NPPESSeptember 5, 2023
Certification dateSeptember 5, 2023
Mailing address11757 E 25th Ave Unit 7208, Aurora, CO 80010-1297

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