Provider Demographics
NPI:1831487693
Name:JENSBY, AMY ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:JENSBY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9915 W MCDOWELL RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4896
Mailing Address - Country:US
Mailing Address - Phone:623-907-4562
Mailing Address - Fax:623-907-4562
Practice Address - Street 1:9915 W MCDOWELL RD
Practice Address - Street 2:SUITE 106
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4896
Practice Address - Country:US
Practice Address - Phone:623-907-4562
Practice Address - Fax:623-907-4562
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD008258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist