# MARK S. JENSEN, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487755005
- **Authorized official:** MRS. ANGELA B SHAFFER (OFFICE MANAGER)
- **Authorized official phone:** (913) 384-2242

## Contact information

- **Practice address:** 8901 W 74TH ST, SUITE \#245, SHAWNEE MISSION, KS 66204-2204
- **Practice address phone:** (913) 384-2242
- **Practice address fax:** (913) 384-4685
- **Mailing address:** 8901 W 74TH ST, SUITE \#245, SHAWNEE MISSION, KS 66204-2204
- **Mailing address phone:** (913) 384-2242
- **Mailing address fax:** (913) 384-4685

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6523 | KS | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 17844026 | BCBS OF KANSAS CITY | KS |
| 01 | — | 383189 | BCBS OF KANSAS | KS |