Jensen, Shane Allen

Jensen, Shane Allen is an individual health care provider with primary practice located at 4114 4Th Ave , Kearney NE 68845-2880. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jensen, Shane Allen can be contacted via phone (308) 237-5166.

Contact Information

Primary practice address
4114 4Th Ave Kearney NE 68845-2880
Phone: (308) 237-5166
Fax: (308) 237-4918
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6114 Nebraska

Profile Details

NPI number 1063592566
LBN Legal business name Jensen, Shane Allen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063592566 NPPES
Nebraska MEDICAID 91-1820685-00

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