Provider Demographics
NPI:1275382624
Name:JAREN JENSEN PLLC
Entity type:Organization
Organization Name:JAREN JENSEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-717-1115
Mailing Address - Street 1:9500 W FLAMINGO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-5721
Mailing Address - Country:US
Mailing Address - Phone:702-570-7333
Mailing Address - Fax:
Practice Address - Street 1:9500 W FLAMINGO RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-5721
Practice Address - Country:US
Practice Address - Phone:702-570-7333
Practice Address - Fax:702-867-8726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty