Individual provider Active NPI

Ishkhan John Bayrakdarian, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fresno, CA
National Provider Identifier
1891719217
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
50037 Issued in CA
Practice address
1616 W Shaw Ave Ste A6
Fresno, CA 93711
Phone
(559) 222-2522
Fax
(559) 222-3022
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 50037 CA Primary

Addresses

Primary practice location

1616 W Shaw Ave Ste A6
Fresno, CA 93711

Mailing address

1616 W Shaw Ave Ste A6
Fresno, CA 93711-3513
Phone (559) 222-2522

Other identifiers 1

IdentifierTypeStateIssuer
203643578MedicaidCA

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

Practice roles

OrganizationSpecialtyStatusNew patients
I.J. Bayrakdarian D.M.D. a Professional Corporation Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Bayrakdarian Madera, D.M.D., Inc., a Professional Dental Corporation Orthodontics and Dentofacial Orthopedics Past Accepting new patients
I J Bayrakdarian DMD a Professional Corporation Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Bayrakdarian Visalia DMD Inc a California Professional Dental Office C Orthodontics and Dentofacial Orthopedics PastSince Nov 15, 2020 Accepting new patients
Bayrakdarian Merced, D.M.D., Inc., a Professional Dental Corporation Orthodontics and Dentofacial Orthopedics PastSince Dec 24, 2023 Accepting new patients
Bayrakdarian Hanford DMD Inc a California Professional Dental Office C Orthodontics and Dentofacial Orthopedics PastSince Oct 19, 2020 Accepting new patients
Bayrakdarian Cedar, D.M.D., Inc., a Professional Dental Corporation Orthodontics and Dentofacial Orthopedics PastSince Apr 21, 2024 Accepting new patients
I J Bayrakdarian DMD a Professional Corporation Orthodontics and Dentofacial Orthopedics PastSince Jul 28, 2019 Accepting new patients

Locations

1616 W Shaw Ave
Ste A6
Fresno, CA 93711
Phone (559) 222-2522

Organizations & group practices 8

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1891719217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 W SHAW AVE STE A6",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113513",
            "telephone_number": "559-222-2522",
            "fax_number": "559-222-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 W SHAW AVE STE A6",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "559-222-2522",
            "fax_number": "559-222-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYRAKDARIAN",
        "first_name": "ISHKHAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "50037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203643578",
            "state": "CA"
        }
    ],
    "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 Oct 12, 2020; 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.