Active NPI
George Christopher Jared, D.D.S.
- Dentist
- El Cajon, CA
National Provider Identifier
1568896264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30129
- Practice address
- 13465 Camino Canada
Ste. 110a
El Cajon, CA 92021-8813 - Phone
- (619) 390-3669
- Fax
- (619) 390-3328
- NPI assigned
- Aug 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 30129 | CA | Primary |
Addresses
Primary practice location
13465 Camino Canada
Ste. 110a
El Cajon, CA 92021-8813
Mailing address
13465 Camino Canada
Ste. 110a
El Cajon, CA 92021-8813
Phone (619) 390-3669
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200310002062 | CA | Practitioner - Dentist | 5092014936 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30129 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377734400000",
"number": "1568896264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13465 CAMINO CANADA",
"address_2": "STE. 110A",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920218813",
"telephone_number": "619-390-3669",
"fax_number": "619-390-3328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13465 CAMINO CANADA",
"address_2": "STE. 110A",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920218813",
"telephone_number": "619-390-3669",
"fax_number": "619-390-3328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARED",
"first_name": "GEORGE",
"middle_name": "CHRISTOPHER",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-29",
"last_updated": "2013-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "30129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.