Provider Demographics
NPI:1174703060
Name:JENSEN, JOANNE MARIE (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:MARIE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1844 SAN MIGUEL DRIVE
Mailing Address - Street 2:SUITE #211
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596
Mailing Address - Country:US
Mailing Address - Phone:925-937-3131
Mailing Address - Fax:925-937-0281
Practice Address - Street 1:1844 SAN MIGUEL DRIVE
Practice Address - Street 2:SUITE #211
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:925-937-3131
Practice Address - Fax:925-937-0281
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA502761223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics