Jack Charles Ohanesian, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

61812 Issued in CA

Practice address

1879 E Fir Ave Ste 101
Fresno, CA 93720-3861

Phone

(559) 322-6060

Fax

(559) 322-7888

NPI assigned

Oct 10, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jack Ohanesian DDS Inc

  • General Practice Dentistry
  • Fresno, CA
  • NPI 1427490531
  NPD Authorized official
• Kellogg and Grant Dental Corporation

  • General Practice Dentistry
  • Fresno, CA
  • NPI 1255885018
  NPD (past)

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1285986505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S CLOVIS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937275316",
            "telephone_number": "559-213-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 E FIR AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203861",
            "telephone_number": "559-322-6060",
            "fax_number": "559-322-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHANESIAN",
        "first_name": "JACK",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sung-Min Oh, MD
• Taeyeon Oh, RPH
• Ohana Care Home Central Valley, LLC
• Deborah Louise Ohanesian, PH.D
• Gary Charles Ohanesian, RPH
• Rachael Ann Ohanian, PH.D.
• Tatev K Ohanian, PHARM.D
• Erika Ohanis, PPS
• Sona Ohanyan
• Michaela Ohki

• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.