NPIMap

Organization Active NPI

Fresno Endodontic Group

  • Endodontics
  • Fresno, CA
National Provider Identifier
1659773208
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
FRESNO ENDODONTIC GROUP
Practice address
1332 W. Herndon
Ste. 103
Fresno, CA 93711
Phone
(559) 437-7120
Fax
(559) 437-7131
NPI assigned
Sep 25, 2014
Last updated
Sep 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Aaron Russell JensenNPI 1154581403
Title
Owner
Phone
(559) 437-7120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1332 W. Herndon
Ste. 103
Fresno, CA 93711

Mailing address

1332 W. Herndon
Ste. 103
Fresno, CA 93711
Phone (559) 437-7120

National Provider Directory

National Provider Directory

Locations

1332 W Herndon Ave
Ste 103
Fresno, CA 93711
Phone (559) 437-7120

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1659773208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 W. HERNDON",
            "address_2": "STE. 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "559-437-7120",
            "fax_number": "559-437-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 W. HERNDON",
            "address_2": "STE. 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "559-437-7120",
            "fax_number": "559-437-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESNO ENDODONTIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-437-7120"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.