Shane Allen Jensen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6114 Issued in NE

Practice address

4114 4TH Ave
Kearney, NE 68845-2880

Phone

(308) 237-5166

Fax

(308) 237-4918

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063592566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 4TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688483048",
            "telephone_number": "308-237-5166",
            "fax_number": "308-237-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 4TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452880",
            "telephone_number": "308-237-5166",
            "fax_number": "308-237-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SHANE",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91-1820685-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Emst Jenny, MD
• Cheri L Jensen, MD
• Gerald I Jensen, M.D.
• Jan Vennell Jensen, MD
• Jerry L Jensen, PHARM D
• Wade Alexander Jensen, DC
• Richard S Jerde, MD
• Jerry Van Winkle, PSYD, LLC
• JG Psychology, LLC
• Anub George John, M.D.

• General Practice Dentistry in Kearney, NE
• Providers in Kearney, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.