Matthew O. Jensen, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

5347421-9923 Issued in UT

Practice address

15331 W Bell Rd Ste 112
Surprise, AZ 85374-4103

Phone

(602) 730-6481

Fax

(602) 730-6482

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Sunshine Smiles Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Surprise, AZ
  • NPI 1952086456
  NPD
• Surprise Pediatric Dentistry, PC

  • Dental Clinic/Center
  • Surprise, AZ
  • NPI 1114462330
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1982703427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15331 W BELL RD",
            "address_2": "SUITE #112",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85374",
            "telephone_number": "602-730-6481",
            "fax_number": "602-730-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15331 W BELL RD STE 112",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744103",
            "telephone_number": "602-730-6481",
            "fax_number": "602-730-6482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6677 W Thunderbird Rd Ste A124",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853063710",
            "country_code": "US",
            "telephone_number": "623-223-9677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MATTHEW",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "5347421-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Surprise",
            "affiliation": "N",
            "endpointDescription": "No in use",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6677 W Thunderbird Rd Ste A124",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853063710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gretchen Jennings, ED.S
• Michelle Nicola Jennings
• Jenny V. Wang DDS II, LLC
• Aaron J. Jensen, PA-C
• Danielle Jensen
• Travis Steven Jensen, DPM
• Naomi Nicole Jimenez, NP
• Gene Jiongco, PHARMD
• JMJ Enterpise LLC
• Angela Johansson, DO

• Pediatric Dentistry in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.