Guy J Jensen, D.D.S., M.S.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

5001856 Issued in WI

Practice address

464 S Hickory St
Suite a
Fond Du Lac, WI 54935-5531

Phone

(920) 923-0111

Fax

(920) 923-0366

NPI assigned

Sep 22, 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

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 31, 2015 through Dec 31, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Oral Surgery Assoc LTD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fond Du Lac, WI
  • NPI 1013020866
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225137227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 S HICKORY ST",
            "address_2": "SUITE A",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549355531",
            "telephone_number": "920-923-0111",
            "fax_number": "920-923-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 S HICKORY ST",
            "address_2": "SUITE A",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549355531",
            "telephone_number": "920-923-0111",
            "fax_number": "920-923-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "GUY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "WI",
            "license": "5001856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Jannette
• Carlene Janssen, L. AC.
• Marcie Ann Janz, APNP
• Edward Joseph Jedlicka, MS, LPC
• Erika Jens
• Brooke Laine Jeske, APNP
• Kevin Andrew Jessen, M.D.
• Fangda Jiang, MD
• Patricia Ann Jirovetz, MS-ATRL
• Sachin S Jogal, MD

• Oral and Maxillofacial Pathology Dentistry in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Oral and Maxillofacial Pathology Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.