Douglas E. Jensen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019017135 Issued in IL

Practice address

5540 S Pulaski Rd
Chicago, IL 60629-4418

Phone

(773) 735-4434

Fax

(773) 735-4993

NPI assigned

Mar 10, 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 29, 2015 through Dec 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1124096425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 LINCOLN LN",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605257401",
            "telephone_number": "708-354-2024",
            "fax_number": "708-354-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294418",
            "telephone_number": "773-735-4434",
            "fax_number": "773-735-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DOUGLAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019017135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10004342",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jens Hussey LLC
• Natalie D Jensema, DNP, RN, ACAGNP
• Cathleen Conway Jensen, OTR/L
• Christopher Jensen, MPT
• Donald Milton Jensen, M.D.
• Emily Jensen
• George Alexander Jensen, NP
• Jacqueline Jensen, OTR L
• Jennifer K Jensen, APRN
• Jessica Margaret Jensen, MA

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.