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NPI Code Detail

MEDICARE: DR. JARRETT JENSEN DDS

MEDICARE: DR. JARRETT JENSEN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1760172266
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JARRETT JENSEN DDS
Provider Business Mailing Address
First Line : 2224 JANET ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-3406
Country : US
Telephone Number : 605-939-1463
Fax Number :
Provider Business Practice Location Address
First Line : 1611 SHERIDAN LAKE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-3423
Country : US
Telephone Number : 605-341-3670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2023
Last Update Date : 05/09/2023

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