Provider Demographics
NPI:1760647572
Name:JEPSEN & ASSOCIATES
Entity Type:Organization
Organization Name:JEPSEN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:JEPSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-452-4556
Mailing Address - Street 1:11411 N PEARL STREET
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233
Mailing Address - Country:US
Mailing Address - Phone:303-452-4556
Mailing Address - Fax:
Practice Address - Street 1:11411 PEARL ST
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-1965
Practice Address - Country:US
Practice Address - Phone:303-452-4556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104288302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization