DR. DOUGLAS E. JENSEN DDS
NPI 1124096425
Dentist - General Practice in Chicago, IL

Q: What is Douglas Jensen's NPI number?

The NPI number for Douglas Jensen is 1124096425. It was assigned to this individual provider in the NPPES registry on March 10, 2006.

Q: What is Douglas Jensen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: Is Douglas Jensen enrolled in Medicare?

No. Douglas Jensen has opted out of Medicare through December 29, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Douglas Jensen was last updated on December 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 10, 2006Opted out of Medicare · through Dec 29, 2027

5540 S PULASKI RD, CHICAGO, IL 60629(773) 735-4434(773) 735-4993 Get Directions Write a Review

NPPES record last updated: December 16, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Douglas E. Jensen Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS E. JENSEN DDS (NPI 1124096425) is an individual general practice provider in Chicago, Illinois, licensed in Illinois (019017135) and active in the NPI registry since March 2006. He has opted out of Medicare through December 29, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124096425

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. DOUGLAS E. JENSENCredential: DDS

Location Address5540 S PULASKI RDChicago, IL 60629-4418

Mailing Address823 Lincoln LnLa Grange Highlands, IL 60525-7401 · (708) 354-2024 · Fax (708) 354-2070

Phone(773) 735-4434

Fax(773) 735-4993

Sole ProprietorNo

Enumeration DateMarch 10, 2006

Last NPPES UpdateDecember 16, 2014

✔ NPI 1124096425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in IL · 019017135

Definition

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.

5540 S PULASKI RD, Chicago, IL 60629

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Other Identifiers 1

Medicaid10004342IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Douglas E. Jensen Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 29, 2015 through December 29, 2027.

Opt-Out Effective DateDecember 29, 2015

Opt-Out In Effect ThroughDecember 29, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60629 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

A KAVALIUNAS MD SC

Internal Medicine

5540 S PULASKI RD
CHICAGO, IL 60629

Cook County (773) 585-2802

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Jensen's NPI number?

The NPI number for Douglas Jensen is 1124096425. It was assigned to this individual provider in the NPPES registry on March 10, 2006.

Where is Douglas Jensen located?

Douglas Jensen practices at 5540 S Pulaski Rd, Chicago, IL 60629. The listed phone number is (773) 735-4434.

What is Douglas Jensen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Douglas Jensen enrolled in Medicare?

No. Douglas Jensen has opted out of Medicare through December 29, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Douglas Jensen accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 2 other insurers list Douglas Jensen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Jensen was last updated on December 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.