Healthcare Provider Details

I. General information

NPI: 1801267018
Provider Name (Legal Business Name): JESSEN'S FAMILY DENTISTRY AND DENTAL HYGIENE, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N.THAYER ST.
SPENCER NE
68777-0287
US

IV. Provider business mailing address

PO BOX 815
ONEILL NE
68763-0815
US

V. Phone/Fax

Practice location:
  • Phone: 402-589-1303
  • Fax:
Mailing address:
  • Phone: 402-336-4812
  • Fax: 402-336-4645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY STENKA
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 402-336-4812