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JACK EDWARD EHLEN DDS
NPI 1356474191
Dentist in Puyallup, WA

Active since March 13, 2007PECOS Enrolled
11208 B 94TH AVE E, PUYALLUP, WA 98373(253) 848-4597(253) 841-7677 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack Edward Ehlen Dds NPPES

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

JACK EDWARD EHLEN DDS (NPI 1356474191) is an individual dentist in Puyallup, Washington, licensed in Washington (6157) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356474191
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameJACK EDWARD EHLENCredential: DDS
Location Address11208 B 94TH AVE EPuyallup, WA 98373-3663
Mailing Address11208 B 94th Ave EPuyallup, WA 98373-3663 · (253) 848-4597 · Fax (253) 841-7677
Phone(253) 848-4597
Fax(253) 841-7677
Sole ProprietorNo
Enumeration DateMarch 13, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1356474191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WA · 6157
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
11208 B 94TH AVE E, Puyallup, WA 98373
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Edward Ehlen Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98373 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
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.

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 Jack Ehlen's NPI number?

The NPI number for Jack Ehlen is 1356474191. It was assigned to this individual provider in the NPPES registry on March 13, 2007.

Where is Jack Ehlen located?

Jack Ehlen practices at 11208 B 94th Ave E, Puyallup, WA 98373. The listed phone number is (253) 848-4597.

What is Jack Ehlen's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jack Ehlen enrolled in Medicare?

Yes. Jack Ehlen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Ehlen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.