Active NPI
Jason Ehtessabian, D.D.S.
- Dentist
- Castle Rock, CO
National Provider Identifier
1770776809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9520
- Practice address
- 3740 Dacoro LN
Suite 140
Castle Rock, CO 80109-2503 - Phone
- (303) 688-6630
- Fax
- (303) 663-6534
- NPI assigned
- Aug 22, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 9520 | CO | Primary |
Addresses
Primary practice location
3740 Dacoro LN
Suite 140
Castle Rock, CO 80109-2503
Mailing address
3740 Dacoro LN
Suite 140
Castle Rock, CO 80109-2503
Phone (303) 688-6630
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 |
|---|---|---|---|
| 9520 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Refresh Snoring and Sleep Apnea Center, PC | Current | Accepting new patients | |
| Jason Ehtessabian PLLC | Current | Accepting new patients | |
| Jason Ehtessabian PLLC | Current | Accepting new patients |
Locations
3740 Dacoro Ln
Ste 140
Castle Rock, CO 80109
Phone (303) 688-6630
9980 Park Meadows Dr
Ste 102
Lone Tree, CO 80124
Phone (303) 221-3342
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Castle Rock, CO
- NPI 1215874490
-
dba Dental Sleep Apnea and Snoring
- General Practice Dentistry
- Lone Tree, CO
- NPI 1700530664
-
- General Practice Dentistry
- Castle Rock, CO
- NPI 1003250416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472601600000",
"number": "1770776809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3740 DACORO LN",
"address_2": "SUITE 140",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801092503",
"telephone_number": "303-688-6630",
"fax_number": "303-663-6534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3740 DACORO LN",
"address_2": "SUITE 140",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801092503",
"telephone_number": "303-688-6630",
"fax_number": "303-663-6534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHTESSABIAN",
"first_name": "JASON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-22",
"last_updated": "2016-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "9520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Castle Rock, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.