Active NPI
Alexander Kisam Jhang, D.D.S.
- Dentist
- Stockton, CA
National Provider Identifier
1255462339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 42664
- Practice address
- 4534 Precissi LN Ste a
Stockton, CA 95207-6213 - Phone
- (209) 957-8940
- Fax
- (209) 957-7990
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 42664 | CA | Primary |
Addresses
Primary practice location
4534 Precissi LN Ste a
Stockton, CA 95207-6213
Mailing address
4141 Poppleton Way
Carmichael, CA 95608-1981
Phone (916) 205-7074
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 013553 | Other | CA | DELTA CARE PMI |
| G93605-01 | Other | CA | DENTI-CAL PROVIDER NUMBER |
| B42664-02 | Other | CA | HEALTHY FAMILY PROGRAM |
| 42664 | Other | CA | CALIFORNIA LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42664 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Jhang DDS Inc | Dentist | Past | Accepting new patients |
Interoperability endpoints
- ajhang@direct.westerndental.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441756800000",
"number": "1255462339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4141 POPPLETON WAY",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956081981",
"telephone_number": "916-205-7074",
"fax_number": "916-944-4126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4534 PRECISSI LN STE A",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952076213",
"telephone_number": "209-957-8940",
"fax_number": "209-957-7990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JHANG",
"first_name": "ALEXANDER",
"middle_name": "KISAM",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2015-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "42664",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA CARE PMI",
"identifier": "013553",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL PROVIDER NUMBER",
"identifier": "G93605-01",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY FAMILY PROGRAM",
"identifier": "B42664-02",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA LICENSE",
"identifier": "42664",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.