Nicholas Paul Jensen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3893 Issued in NM

Practice address

770 Broadmoor Blvd NE
Rio Rancho, NM 87124-3442

Phone

(505) 891-0554

Fax

(505) 891-0552

NPI assigned

Jun 20, 2013

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

Enrolled in NM

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• 770 Broadmoor Rio Rancho Professional LLC

  • Dentist
  • Rio Rancho, NM
  • NPI 1841890373
  NPD (past)
• Sundance Dental Care of Rio Rancho, LLC

  • Dentist
  • Rio Rancho, NM
  • NPI 1164725503
  NPD (past)

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1306285671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 BROADMOOR BLVD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871243442",
            "telephone_number": "505-891-0554",
            "fax_number": "505-891-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 BROADMOOR BLVD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871243442",
            "telephone_number": "505-891-0554",
            "fax_number": "505-891-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "NICHOLAS",
        "middle_name": "PAUL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi C Jasper-Jones
• Terry Maurice Jasper Jr.
• JD Behavioral Supports, LLC
• Rebecca S Jee, CNP
• Margaret Madeline Jennett
• Caroline Jimenez, RN
• Veronica Jimenez, BMS
• Charles R Jobbins, BMS
• Gregory E. Jochems, MD
• Jabez Babu John, MD

• General Practice Dentistry in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.