Peder Jensen, DMD, PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2544 Issued in AR

Legal business name

PEDER JENSEN, DMD, PA

Practice address

2501 Crestwood Rd
Ste 102
North Little Rock, AR 72116-6864

Phone

(501) 758-6182

Fax

(501) 758-6184

NPI assigned

Jun 19, 2008

Organization subpart

No

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

Authorized official

Name

Zelma Seymore

Title

Office Manager

Phone

(501) 758-6182

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1063673440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CRESTWOOD RD",
            "address_2": "STE 102",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166864",
            "telephone_number": "501-758-6182",
            "fax_number": "501-758-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CRESTWOOD RD",
            "address_2": "STE 102",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166864",
            "telephone_number": "501-758-6182",
            "fax_number": "501-758-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDER JENSEN, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "SEYMORE",
        "authorized_official_first_name": "ZELMA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-758-6182"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AR",
            "license": "2544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joredia Patton
• Jennifer Ann Paulson, PH.D.
• PDG Dental Group PLLC
• Carla Jobeth Peace, PA-C
• Parker Drake Pearson, DMD
• Jody Peebles, M.D.
• Rebecca M Pence
• Andrew Seth Pennington, LMSW
• Beau Tanner Pennington, MD
• People Advocating Transitions

• Periodontics in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Periodontics in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.