DR. PHLLIP M. JENSEN (NPI# 1699892042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699892042 |
| Entity Type | Individual |
| Full Name | DR. PHLLIP M. JENSEN |
| Credential | D.M.D. |
| Practice Address |
2606 Marketplace Dr Springfield IL 62702-1467 |
| Practice Telephone | 2177538690 |
| Mailing Telephone | 2177538690 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
019-020843 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 019020843 | 05 | |
| IL | BCBS | 31898 33225 | 01 |
| IL | HEALTH ALLIANCE | 033519 | 01 |
| IL | UNITED CONCORDIA | 442331 | 01 |
| Street Address |
2606 MARKETPLACE DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-1467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134494289 | Phillip M. Jensen, D.m.d., P.C. | Dentist | 2606 Marketplace Dr, Springfield, IL 62702-1467 | 2012-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669960027 | New England Family Dentistry,pc | Dentist | 366 Cooley St, Springfield, MA 01128-1144 | 2018-05-01 |
| 1841739588 | Dr. Shahid Aziz Oral and Maxillofacial Surgery LLC | Dentist | 118 Mapes Ave, Springfield, NJ 07081-3220 | 2017-02-14 |
| 1740490648 | Phuong Ngoc Nguyen | Dentist | 9328 Castle Hill Rd, Springfield, VA 22153-3900 | 2007-05-22 |
| 1063564938 | Richard William Alcorn | Dentist | 2871 Stanton St, Springfield, IL 62703-5508 | 2007-01-18 |
| 1881760254 | Barry Richard Wolinsky | Dentist | 493 Morris Ave, Springfield, NJ 07081-1061 | 2006-11-28 |
| 1487725719 | Roy Peter Guerin IIi | Dentist | 2530 Game Farm Rd, Springfield, OR 97477-7513 | 2006-11-10 |
| 1598876260 | Kevin Louis Trombly | Dentist | 1575 Wilbraham Rd, Springfield, MA 01119 | 2006-08-31 |
| 1346352218 | Louis Dennis Scannura | Dentist | 3007 Spring Mill Dr, Springfield, IL 62704-6558 | 2006-08-31 |
| 1295773042 | Margo J Freedberg | Dentist | 475 Morris Ave, Springfield, NJ 07081-1005 | 2006-06-03 |
| 1033188842 | James A Maxwell Jr. | Dentist | 2210 Olympic St, Springfield, OH 45503-2737 | 2006-03-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on DR. PHLLIP M. JENSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.