Provider Demographics
NPI:1275652133
Name:JENSEN, JAMES DEAN (DDS, MS, PA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DEAN
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DDS, MS, PA
Other - Prefix:
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Mailing Address - Street 1:1605 G AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5750
Mailing Address - Country:US
Mailing Address - Phone:972-422-0277
Mailing Address - Fax:972-422-0288
Practice Address - Street 1:1605 G AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5750
Practice Address - Country:US
Practice Address - Phone:972-422-0277
Practice Address - Fax:972-422-0288
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX146481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics