Healthcare Provider Details

I. General information

NPI: 1437240405
Provider Name (Legal Business Name): DANA ANDREW JENSEN D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SE 120TH AVE STE 800
VANCOUVER WA
98683-4094
US

IV. Provider business mailing address

300 SE 120TH AVE STE 800
VANCOUVER WA
98683-4094
US

V. Phone/Fax

Practice location:
  • Phone: 360-260-3290
  • Fax:
Mailing address:
  • Phone: 360-260-3290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDENT.DE.70140146
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: