Mark Jensen DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2376 Issued in AZ

Legal business name

MARK JENSEN DDS

Practice address

18275 N 59TH Ave
Suite 128
Glendale, AZ 85308

Phone

(602) 978-3643

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Mark Jensen, DDS

Title

Owner

Phone

(602) 978-3643

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1831140045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "SUITE 128",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-978-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "SUITE 128",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-978-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK JENSEN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-978-3643",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "2376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.