Jennifer Yedigarov

Primary specialty

DentistTaxonomy code 122300000X

License

112153 Issued in CA

Practice address

200 S Wells Rd Ste 225
Ventura, CA 93004-1382

Phone

(805) 659-0560

Fax

(805) 659-9275

NPI assigned

Feb 13, 2024

Sex

Female

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

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

Interoperability endpoints

• Direct secure messaging: jyedigarov834626@direct.ochin.org

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1629832324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD STE 225",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041382",
            "telephone_number": "805-659-0560",
            "fax_number": "805-659-9275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11301 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900731003",
            "country_code": "US",
            "telephone_number": "310-478-3711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEDIGAROV",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "112153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Yasuda
• Michelle Yates, M.D.
• Crystal Yaya
• Sandra K Ybarra, F.N.P.
• Joohee Yeam, DO, MPH
• Stacey Tsai Yee, ACSW
• Ashley Yepes Fernandez
• Lupe Yepez- Michel, NP
• Joseph George Yered, PHARMD
• Alexander Yerkes

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.