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General NPI Number Information
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NPI Number | 1487755005
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Entity Type | Organization
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Legal Business Name | MARK S. JENSEN, DDS, PA
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8901 W 74TH ST SUITE #245
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-2204
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Country | US
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Telephone | 913-384-2242
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Fax | 913-384-4685
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Provider Business Mailing Address
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Address Line | 8901 W 74TH ST SUITE #245
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-2204
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Country | US
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Telephone | 913-384-2242
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Fax | 913-384-4685
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANGELA B SHAFFER
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Credential |
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Telephone | 913-384-2242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6523
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License Number State | KS
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