FRESNO ENDODONTIC GROUP (NPI# 1659773208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659773208 |
| Entity Type | Organization |
| Organization Name | FRESNO ENDODONTIC GROUP |
| Practice Address |
1332 W. Herndon Ste. 103 Fresno CA 93711 |
| Practice Telephone | 5594377120 |
| Practice Fax Number | 5594377131 |
| Mailing Telephone | 5594377120 |
| Mailing Fax Number | 5594377131 |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |
| Authorized Official Name | AARON RUSSELL JENSEN (OWNER) |
| Authorized Official Telephone | 5594377120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Street Address |
1332 W. HERNDON STE. 103 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104464684 | Kazi Shafiul Moula | Dentist | Western Dental/ Brident 150bfo, 3077 W Shaw Ave, Fresno, CA 93711 | 2019-12-16 |
| 1760037063 | Armine Petrosyan | Nurse Practitioner | 427 W Beford Ave Suite 103, Fresno, CA 93711 | 2019-08-05 |
| 1912489360 | Shoua Nelson | Nurse Practitioner | 2490 W. Shaw Avenue Suite 101, Fresno, CA 93711 | 2018-09-02 |
| 1245725506 | Promesa Behavioral Health-barstow | Community Based Residential Treatment Facility, Mental Illness | 1415 W Barstow Ave, Fresno, CA 93711 | 2018-06-28 |
| 1407344138 | Aidan Mechem | Behavior Technician | 5140 N. Fruit Avene, Fresno, CA 93711 | 2018-04-27 |
| 1841798840 | Michael Ramos IIi | Behavior Technician | 1690 N Shaw Ave, 102, Fresno, CA 93711 | 2018-01-25 |
| 1962913467 | Dhara Devendrakumar Patel | Pharmacist | 740 West Alluvial Avenue, Suite 101, Fresno, CA 93711 | 2017-10-24 |
| 1588183636 | Bianca Arteaga | Counselor | 7485 N. Palm Ave., Suite 103, Fresno, CA 93711 | 2017-09-10 |
| 1346763158 | Powell Pediatric Dentistry Ingram Partnership | Dentist | 7761 N Ingram Ave, Suite 101, Fresno, CA 93711 | 2017-07-24 |
| 1982124202 | Justine Syera Balbas | Counselor | 2766 W. Celeste Ave., Unit 103, Fresno, CA 93711 | 2017-06-27 |
| Find all providers in zip 93711 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497223390 | Yan Kalika Dental Corporation | Dentist | 5657 E Kings Canyon Rd Ste 107, Fresno, CA 93727-4653 | 2018-11-08 |
| 1639504632 | Jessica Nguyen | Dentist | 6307 N Fresno St Ste 102, Fresno, CA 93710-5284 | 2013-09-09 |
| 1417167230 | Wayne V. Hotzakorgian | Dentist | 6307 N. Fresno St., Ste 102, Fresno, CA 93710 | 2007-05-23 |
| 1881812253 | Craig Teruo Nii | Dentist | 5446 N. Palm Ave., #109, Fresno, CA 93704 | 2007-04-23 |
| 1518181932 | Alvin Kiyomi Hayashi | Dentist | 4824 N 1st St, Suite 106, Fresno, CA 93726-0523 | 2007-04-13 |
| 1740403930 | Victor Y Yaghoubi-mirzayan | Dentist | 6177 N Thesta St, Suite 102, Fresno, CA 93710-8600 | 2007-04-10 |
| 1386763670 | Ramsey Y Doo | Dentist | 7181 N Millbrook Ave Ste 111, Fresno, CA 93720-3364 | 2007-03-28 |
| 1922127620 | Kevin T. Nii | Dentist | 6307 N. Fresno St., Ste 102, Fresno, CA 93710 | 2007-03-27 |
| 1619008745 | Tuan Hung Nguyen | Dentist | 1332 W Herndon Ave Ste 103, Fresno, CA 93711-7118 | 2007-03-08 |
| 1124109632 | Gerald Layne Danielson | Dentist | 6177 N Thesta St Ste 102, Fresno, CA 93710-8600 | 2006-10-18 |
| Find all providers in FRESNO | ||||
Please comment or provide details below to improve the information on FRESNO ENDODONTIC GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.