Provider Demographics
NPI:1548492887
Name:JENSEN, JAMON (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:JAMON
Middle Name:
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-3814
Mailing Address - Country:US
Mailing Address - Phone:303-449-3250
Mailing Address - Fax:
Practice Address - Street 1:10231 KNOLL CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-8051
Practice Address - Country:US
Practice Address - Phone:435-241-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT704613699211223X0400X
CODEN.002021911223X0400X
TX261181223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics