Individual provider Active NPI

Jenny Apekian, DDS

  • Dentist
  • Sacramento, CA
National Provider Identifier
1083801807
Registry record updated Apr 12, 2021
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55804 Issued in CA
Practice address
2831 G St Ste 100
Sacramento, CA 95816-3783
Phone
(916) 441-5800
Fax
(916) 441-5848
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 55804 CA Primary

Addresses

Primary practice location

2831 G St Ste 100
Sacramento, CA 95816-3783

Mailing address

2831 G St Ste 100
Sacramento, CA 95816-3783
Phone (916) 441-5800

Other identifiers 1

IdentifierTypeStateIssuer
55804OtherCADENTAL LICENSE #

Other names 1

  • Jenny Vassilian Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121001301 CA Order and Referring Only - DentistPractitioner - Dentist 3870896046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1083801807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 G ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163783",
            "telephone_number": "916-441-5800",
            "fax_number": "916-441-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 G ST STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163783",
            "telephone_number": "916-441-5800",
            "fax_number": "916-441-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APEKIAN",
        "first_name": "JENNY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE #",
            "identifier": "55804",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "VASSILIAN",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.