Michael Kenneth Jensen, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6167 Issued in WA

Practice address

406 SE 131St Ave
Ste 202
Vancouver, WA 98683-4004

Phone

(360) 253-9542

Fax

(360) 253-9589

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

Yes

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 WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Michael Jensen DMD PC

  • Dental Clinic/Center
  • Vancouver, WA
  • NPI 1720553993
  NPD (past) Authorized official

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1386649333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 NE 131ST ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986864904",
            "telephone_number": "360-574-8307",
            "fax_number": "360-253-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE",
            "address_2": "STE 202",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "360-253-9542",
            "fax_number": "360-253-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MICHAEL",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "D6167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernie Ray Jensen, LMHCA
• Heather Jensen, RN
• Kala Jensen, M.S., LPC, LMHC
• Kirsti Sonnenburg Jensen, LMP
• Makeda Jensen
• Rylee Michelle Jensen, AU.D
• Erik Jenson, DMD
• Daniel Jeppesen
• Jeremy H Diehl, D.D.S., M.S.D., PC
• Jeremy Houtsma Counseling LLC

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.