Jason A Fomich, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19903 Issued in OH

Practice address

701 W Central Ave
Delaware, OH 43015-1414

Phone

(740) 362-6381

NPI assigned

Aug 11, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609887876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W CENTRAL AVE",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151414",
            "telephone_number": "740-362-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W CENTRAL AVE",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151414",
            "telephone_number": "740-362-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMICH",
        "first_name": "JASON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "19903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023054",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Braeden Flint
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• Fomenky LLC
• Michael Fomenky, CNP
• Foot & Ankle Wellness Center
• Michelle Lynn Ford, LPN
• Erica McCuen Foster
• Kathrine Fox, LPC
• Jennifer Nicole Franklin Kearns

• General Practice Dentistry in Delaware, OH
• Providers in Delaware, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.