Active NPI
Jared Schultz, DMD
- Dentist
- Fresno, CA
National Provider Identifier
1669856936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31249
- Practice address
- 1210 E Kelso Ave
Fresno, CA 93720 - Phone
- (559) 940-0017
- NPI assigned
- Jul 16, 2015
- Last updated
- Jul 20, 2015
- 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 | 31249 | TX | Primary |
Addresses
Primary practice location
1210 E Kelso Ave
Fresno, CA 93720
Mailing address
1210 E Kelso Ave
Fresno, CA 93720-1849
Phone (559) 940-0017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31249 | TX | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ferris RSVS PLLC | Dentist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437350400000",
"number": "1669856936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 E KELSO AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937201849",
"telephone_number": "559-940-0017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 E KELSO AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "93720",
"telephone_number": "559-940-0017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "JARED",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-16",
"last_updated": "2015-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "31249",
"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 Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.