Active NPI
Jay D. Jensen, D.D.S.
- General Practice Dentistry
- Salt Lake City, UT
National Provider Identifier
1598866469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 139107
- Practice address
- 2043 E 2700 S
Salt Lake City, UT 84109-1720 - Phone
- (801) 467-9111
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 139107 | UT | Primary |
Addresses
Primary practice location
2043 E 2700 S
Salt Lake City, UT 84109-1720
Mailing address
3098 S Highland Dr
Ste 400
Salt Lake City, UT 84106-3618
Phone (801) 467-9111
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160120001632 | UT | Order and Referring Only - Dentist | 8921301227 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 139107 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452988800000",
"number": "1598866469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3098 S HIGHLAND DR",
"address_2": "STE 400",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841063618",
"telephone_number": "801-467-9111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 E 2700 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841091720",
"telephone_number": "801-467-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "JAY",
"middle_name": "D.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2016-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "139107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2016; 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.