Active NPI
Ryan Jensen, DMD
- Dentist
- Sioux City, IA
National Provider Identifier
1184064222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 09011
- Practice address
- 4100 Morningside Ave
Sioux City, IA 51106-2974 - Phone
- (712) 274-2038
- NPI assigned
- Jul 3, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 09011 | IA | Primary |
Addresses
Primary practice location
4100 Morningside Ave
Sioux City, IA 51106-2974
Mailing address
4100 Morningside Ave
Sioux City, IA 51106-2974
Phone (712) 274-2038
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09011 | IA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Douglas a. Wheelock, DDS, PC | Past | Accepting new patients | |
| Baller and Wineland LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Sioux City, IA
- NPI 1801593280
-
- General Practice Dentistry
- Sioux City, IA
- NPI 1801225578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372809600000",
"number": "1184064222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 MORNINGSIDE AVE",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511062974",
"telephone_number": "712-274-2038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 MORNINGSIDE AVE",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511062974",
"telephone_number": "712-274-2038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-03",
"last_updated": "2013-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "09011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.