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DR. KACI B. JENSEN PLLC NPI 1255339297


NPI Information

NPI: 1255339297
Provider Name: DR. KACI B. JENSEN, PLLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
9755 W LEO DR
BOISE, ID
ZIP 83709
Phone: (208) 791-4926
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DR. KACI B. JENSEN, PLLC is a general practice dentist in Boise, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. KACI B. JENSEN, PLLC NPI is 1255339297. The provider is registered as an organization entity type.

The provider's business location address is:

9755 W LEO DR
BOISE, ID
ZIP 83709-249
Phone: (208) 791-4926

The provider's authorized official is Kaci B. Jensen .
The authorized official title is Owner and has the following contact phone number (208) 791-4926.

The enumeration date for this NPI number is 7/13/2005 and was last updated on 3/7/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD0000XClinic/CenterDental2000159748MISSOURINo
21223G0001XDentistGeneral PracticeD-4034IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1807602800MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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