John Ryan Jeppsen, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5809 Issued in NM

Practice address

4411 San Mateo Blvd NE Ste E1
Albuquerque, NM 87109

Phone

(505) 872-4867

Fax

(505) 872-9380

NPI assigned

Feb 29, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1437519758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 SAN MATEO BLVD NE STE E1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092000",
            "telephone_number": "505-872-4867",
            "fax_number": "972-590-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SAN MATEO BLVD NE STE E1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-872-4867",
            "fax_number": "505-872-9380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "702-930-5602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEPPSEN",
        "first_name": "JOHN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "5809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Michelle Jensen
• Amanda Jenson
• Nadine Jenson
• Sigmund G. Jenssen, M.D.
• Leota Merle Jentzen, APRN-CNS
• Jodie Jepson
• Jennifer Jernigan, MD
• Danail Jesfjeld, DOULA
• Kirstin Jeske, MS CCC-SLP
• Jessica R Jespersenchavez, LMSW-P

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, 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 Sep 13, 2019; 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.