Dayne R Jensen, M.D., D.M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

30823 Issued in OK

Practice address

2100 NW 63Rd St
Oklahoma City, OK 73116-5111

Phone

(405) 842-6677

NPI assigned

Feb 5, 2010

Last updated

Jan 29, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 4, 2023 through Apr 4, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Heights Oral & Facial Surgery PLLC

  dba Legacy Heights Oral & Facial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Farmington, UT
  • NPI 1912507153
  NPD Authorized official
• Layton Oral Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Layton, UT
  • NPI 1770238016
  NPD (past) Authorized official
• St. George Red Rocks PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • St George, UT
  • NPI 1356084107
  NPD (past) Authorized official
• Red Rocks Surgical Center PC

  • Ambulatory Surgical Clinic/Center
  • St George, UT
  • NPI 1457076903

  Oral and Maxillofacial Surgery

  NPD

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1881926509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731165111",
            "telephone_number": "405-842-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731165111",
            "telephone_number": "405-842-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DAYNE",
        "middle_name": "R",
        "credential": "M.D., D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-05",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "6860",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "30823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Alexandra Jennings, M.D.
• McKenzie Jennings, COTA/L
• Serena L Jennings
• Virgil L. Jennings Jr.
• Crystal Renae Jensen, PRSS
• Lea Jensen, BS IN LEADERSHIP
• Margaret Elizabeth Jensen, PA-C
• Nathan Jensen
• Shelby Lynn Jensen, IBCLC
• Zoe Jeon

• Surgery Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.