Individual provider Active NPI

Jason Ehtessabian, D.D.S.

  • Dentist
  • Castle Rock, CO
National Provider Identifier
1770776809
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9520 Issued in CO
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

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
9520COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Refresh Snoring and Sleep Apnea Center, PC Current Accepting new patients
Jason Ehtessabian PLLC CurrentSince Mar 20, 2025 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

  • FHIR API: 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.

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.

Verify at the official NPI Registry.