Healthcare Provider Details

I. General information

NPI: 1528687043
Provider Name (Legal Business Name): CHANDLER JANSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 S MINNESOTA AVE
SIOUX FALLS SD
57108-2591
US

IV. Provider business mailing address

6701 S MINNESOTA AVE
SIOUX FALLS SD
57108-2591
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-6960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number0538
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: