Provider Demographics
NPI:1356545891
Name:JENSEN, NATALIE JOY (DDS)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:JOY
Last Name:JENSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:JOY
Other - Last Name:MENDENHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:506 NE 107TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-1574
Mailing Address - Country:US
Mailing Address - Phone:816-605-0034
Mailing Address - Fax:816-399-5090
Practice Address - Street 1:506 NE 107TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-1574
Practice Address - Country:US
Practice Address - Phone:816-605-0034
Practice Address - Fax:816-399-5090
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070145401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice