Organization Active NPI

Rogue River Family Dental

Doing business as D Charles Jensen DDS

  • Dental Clinic/Center
  • Rockford, MI
National Provider Identifier
1134868862
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ROGUE RIVER FAMILY DENTAL
Doing business as
D Charles Jensen DDS
Practice address
2 N Monroe St
Rockford, MI 49341-1228
Phone
(616) 866-7720
NPI assigned
Jun 1, 2022
Last updated
Jun 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Mrs. Shellie J Looks
Title
Administration
Phone
(616) 443-2387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2 N Monroe St
Rockford, MI 49341-1228

Mailing address

2 N Monroe St
Rockford, MI 49341-1228
Phone (616) 866-7720

Other names 1

  • D Charles Jensen DDS Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@rogueriverdentistry.com Direct

National Provider Directory

National Provider Directory

Locations

2 N Monroe St
Rockford, MI 49341
Phone (616) 866-0869

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1134868862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N MONROE ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411228",
            "telephone_number": "616-866-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N MONROE ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411228",
            "telephone_number": "616-866-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE RIVER FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "LOOKS",
        "authorized_official_first_name": "SHELLIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "616-443-2387",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@rogueriverdentistry.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 N Monroe St",
            "city": "Rockford",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493411228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "D Charles Jensen DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.