Jason P. Ganong, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS036238 Issued in PA

Practice address

Unit 26610
Wuerzburg Dental Activity Credentials Office
Apo Ae, NY 09244

Phone

(931) 804-3933

Fax

(931) 804-2524

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972580249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIT 26610",
            "address_2": "WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "APO AE",
            "state": "NY",
            "postal_code": "09244",
            "telephone_number": "931-804-3933",
            "fax_number": "931-804-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIT 26610",
            "address_2": "WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "APO AE",
            "state": "NY",
            "postal_code": "09244",
            "telephone_number": "931-804-3933",
            "fax_number": "931-804-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANONG",
        "first_name": "JASON",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Eric Davis, P.T.
• Patricia Anne Deland, RDH
• Andrew Draper, PHARMD
• Klaus Eastman, D.D.S.
• Kathryn Elizabeth Fournie
• Matthew Ghiz, D.D.S., M.S.
• Keith Michael Gressell, DMD
• Tam S Hager, D.M.D.
• Nadia Halimi
• Nolaann Hamm, RDH

• All providers in Apo Ae, NY
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.