Dr. G. Shane Jessen
Oral and Maxillofacial Pathology
1508 E Skyline Dr Ste 800
Ogden
, Utah 84405-4889
Dr. G. Shane Jessen
Oral and Maxillofacial Pathology
1508 E Skyline Dr Ste 800
Ogden
, Utah 84405-4889
(801) 479-3219
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. G. Shane Jessen
- 1508 E Skyline Dr Ste 800
- Ogden, UT
- Zip : 84405-4889
- Fax : (801) 479-3219
- Phone : (801) 479-8200
Second Address
- Dr. G. Shane Jessen
- 1508 E Skyline Dr Ste 800
- Ogden, UT
- Zip : 84405-4889
- Fax : (801) 479-3219
- Phone : (801) 479-8200
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 52199299924 | UT |
National Provider Identifier
| NPI | 1548349251 |
|---|---|
| Provider Name | Dr. G. Shane Jessen |
| First Address | Ogden, UT 84405-4889 |
| Second Address | Ogden, UT 84405-4889 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/11/2006 |
| Last Update Date | 17/12/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.