Provider Demographics
NPI:1548394646
Name:JAMES D. JENSEN, D.M.D.,INC.
Entity Type:Organization
Organization Name:JAMES D. JENSEN, D.M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:330-494-6605
Mailing Address - Street 1:4580 STEPHENS CIR NW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3644
Mailing Address - Country:US
Mailing Address - Phone:330-494-6605
Mailing Address - Fax:330-494-1224
Practice Address - Street 1:4580 STEPHENS CIR NW
Practice Address - Street 2:SUITE 102
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3644
Practice Address - Country:US
Practice Address - Phone:330-494-6605
Practice Address - Fax:330-494-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental