Individual provider Active NPI

Avo Hratch Fronjian, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1841390358
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47891 Issued in CA
Practice address
9636 Tierra Grande St Ste 105
San Diego, CA 92126-6502
Phone
(858) 549-4511
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 47891 CA Primary

Addresses

Primary practice location

9636 Tierra Grande St Ste 105
San Diego, CA 92126-6502

Mailing address

9636 Tierra Grande St Ste 105
San Diego, CA 92126-6502
Phone (858) 549-4511

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160225002198 CA Order and Referring Only - DentistPractitioner - Dentist 4183929375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avo H Fronjian DMD Inc Dentist CurrentSince Sep 3, 2025 Accepting new patients

Locations

9636 Tierra Grande St
Ste 105
San Diego, CA 92126
Phone (858) 549-4511

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841390358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9636 TIERRA GRANDE ST STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921266502",
            "telephone_number": "858-549-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9636 TIERRA GRANDE ST STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921266502",
            "telephone_number": "858-549-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRONJIAN",
        "first_name": "AVO",
        "middle_name": "HRATCH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.