Jessen Omfs Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

52199299924 Issued in UT

Legal business name

JESSEN OMFS INC

Practice address

1508 E Skyline Dr
Suite 800
Ogden, UT 84405-4846

Phone

(801) 479-8200

Fax

(801) 479-3219

NPI assigned

Nov 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Shane Jessen, DDSNPI 1548349251

Title

Owner

Phone

(801) 479-8200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Shane Jessen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Ogden, UT
  • NPI 1548349251
  Medicare reassignment NPD Authorized official
• F. Zane Jessen, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Ogden, UT
  • NPI 1205913035
  NPD (past)

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1184991895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 E SKYLINE DR",
            "address_2": "SUITE 800",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054846",
            "telephone_number": "801-479-8200",
            "fax_number": "801-479-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 E SKYLINE DR",
            "address_2": "SUITE 800",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054846",
            "telephone_number": "801-479-8200",
            "fax_number": "801-479-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSEN OMFS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-23",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "JESSEN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-479-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "52199299924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scot Bram Jensen, PA-C
• Stephanie Jensen
• Hallie Jenson
• Robert Lawrence Jenson, LPC
• Daneen Conley Jeppson, NP
• F. Zane Jessen, DDS
• Gregory Shane Jessen, DDS
• Mareille Jewett
• Tera Luane Jimenez, LPN
• Audrey A Jiricko, MD

• Oral and Maxillofacial Surgery (Dentist) in Ogden, UT
• Providers in Ogden, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.