Gregory Shane Jessen, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5219929-9924 Issued in UT

Practice address

1508 E Skyline Dr Ste 800
Ogden, UT 84405-4889

Phone

(801) 479-8200

Fax

(801) 479-3219

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

Virginia Commonwealth Univ School of Dentistry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gjessen511081@direct.med.utah.edu

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.

• Jessen Omfs Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Ogden, UT
  • NPI 1184991895
  Medicare reassignment NPD Authorized official
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Dental Services

  dba Univ. of Utah Hosp. Plastic Surgery-Dental

  • Plastic and Reconstructive Surgery Physician
  • Salt Lake City, UT
  • NPI 1346633203
  Medicare reassignment NPD
• University of Utah Adult Services

  dba UUHSC Madsen Health Center Sports Med

  • Sports Medicine (Family Medicine) Physician
  • Salt Lake City, UT
  • NPI 1164826665
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Dental Services

  dba University Hospital School of Dentistry

  • Dental Clinic/Center
  • Salt Lake City, UT
  • NPI 1821446279
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  dba Intermountain Health McKay-Dee Hospital

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1548349251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 E SKYLINE DR STE 800",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054889",
            "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 STE 800",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054889",
            "telephone_number": "801-479-8200",
            "fax_number": "801-479-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "GREGORY",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "UT",
            "license": "5219929-9924",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "UT",
            "license": "52199299924",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "5219929-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GJESSEN511081@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hallie Jenson
• Robert Lawrence Jenson, LPC
• Daneen Conley Jeppson, NP
• Jessen Omfs Inc
• F. Zane Jessen, DDS
• Mareille Jewett
• Tera Luane Jimenez, LPN
• Audrey A Jiricko, MD
• Jlloydnp
• Suzanne Jodray

• 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.