Provider Demographics
NPI:1225207251
Name:JENSEN, JAREN TOLMAN (DDS)
Entity Type:Individual
Prefix:
First Name:JAREN
Middle Name:TOLMAN
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 W FLAMINGO RD
Mailing Address - Street 2:#200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-5719
Mailing Address - Country:US
Mailing Address - Phone:702-614-1792
Mailing Address - Fax:
Practice Address - Street 1:3896 N MARTIN L KING BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-6603
Practice Address - Country:US
Practice Address - Phone:702-614-1792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-24
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD74571223P0221X
NVS6-1001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry