Provider Demographics
NPI:1851838551
Name:JENSEN, ANGELA K (RDH)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:K
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 E 120TH AVE
Mailing Address - Street 2:#104
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-2484
Mailing Address - Country:US
Mailing Address - Phone:303-254-8828
Mailing Address - Fax:
Practice Address - Street 1:2300 E 120TH AVE
Practice Address - Street 2:#104
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-2484
Practice Address - Country:US
Practice Address - Phone:303-254-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002024153124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist