Andrew John Pakchoian, D.D.S.

Primary specialty

Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X

License

60579 Issued in CA

Practice address

2005 Knight Lane BLDG H
Attn: Medical Staff Services, Navy Medicine Support Com
Jacksonville, FL 32212-0140

Phone

(619) 532-8600

NPI assigned

Aug 9, 2010

Last updated

Aug 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1356656805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 CHARDONNAY DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE BLDG H",
            "address_2": "ATTN: MEDICAL STAFF SERVICES, NAVY MEDICINE SUPPORT COM",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "619-532-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKCHOIAN",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "CA",
            "license": "60579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Painter, BCCC
• Krystal Imani Paisley, AS, LMT
• Raymond Pak, MD
• Sang-Woo Pak, M.D.
• Song Hyon Pak, M.D.
• Ryan Alexander Pal, APRN
• Palace of Peace Inc
• Carlos Palacio, M.D.
• Mary L Palacio
• Samantha Paladino

• Dentist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.