DR. DAMON TY JENSEN (NPI# 1851598437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851598437 |
| Entity Type | Individual |
| Full Name | DR. DAMON TY JENSEN |
| Other Name | DR. DAMON TY JENSEN |
| Credential | DDS |
| Practice Address |
Bureau of Medicine & Surgery Detachment Jacksonville Nas Jacksonville Building 554 Jacksonville FL 32212-0140 |
| Mailing Address |
Po Box 1478 P.o. Box 1478 Afton WY 83110-1478 |
| Practice Telephone | 1877772437 |
| Mailing Telephone | 1877772437 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2015-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | NOT ISSUED TO DA | WY | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1181 | WY | Dental Providers |
| Street Address |
BUREAU OF MEDICINE & SURGERY DETACHMENT JACKSONVILLE NAS JACKSONVILLE BUILDING 554 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212-0140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396017927 | Robert James Orgill | Registered Nurse | Bureau of Medicine & Surgery Detachment Jacksonville, Nas Jacksonville, Jacksonville, FL 32212-0140 | 2012-01-27 |
| 1750514089 | Katherine Elizabeth Pierce | Psychologist | Bureau of Medicine & Surgery Detachment Jacksonville, Nas Jacksonville Building 554, Jacksonville, FL 32212-0140 | 2009-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| 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 |
|---|---|---|---|---|
| 1154760411 | Tyler J Holley | Dentist | University of Florida- Jacksonville, 653-1 West 8th Street, Jacksonville, FL 32209 | 2013-06-20 |
| 1851602734 | Carlo Enrico Guevara | Dentist | 4540 Southside Blvd Ste 1001, Jacksonville, FL 32216-5495 | 2010-06-25 |
| 1306073754 | Bouali Frederick Amoli | Dentist | 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 | 2009-06-12 |
| 1154555035 | Salam Omar Salman | Dentist | 653 W. 8th Street, Uf - Jacksonville Dept. of Oral & Maxillofacial Surgery, Jacksonville, FL 32209 | 2009-05-07 |
| 1316151301 | Scott Roberts Sklenicka | Dentist | 2511 Saint Johns Bluff Rd S, Suite 207, Jacksonville, FL 32246-2346 | 2007-05-09 |
| 1851417406 | North Florida Oral & Facial Surgery, P.a. | Dentist | 11481 Old Saint Augustine Rd Ste 203, Jacksonville, FL 32258-1475 | 2007-03-22 |
| 1992832059 | Vanni Russ Strenta | Dentist | 3914 Blanding Blvd, Jacksonville, FL 32210-5413 | 2007-02-27 |
| 1184760480 | Gregory Joseph Groshan | Dentist | 3007 Hartley Rd, Jacksonville, FL 32257-6201 | 2007-01-30 |
| 1477606267 | Gregory W Hartley | Dentist | 4181 Southpoint Dr E, Suite 200, Jacksonville, FL 32216-0993 | 2007-01-18 |
| 1366591265 | Pairot Tayapongsak | Dentist | 7101 Normandy Blvd, Jacksonville, FL 32205-6211 | 2007-01-09 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
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| 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.