JACK H KOUMJIAN DDS NPI 1073629390

NPI Information

NPI: 1073629390
Provider Name: JACK H KOUMJIAN, DDS
Classification: Dentist - 1223P0700X
Entity Type: Individual

Specialization: Prosthodontics

PECOS Registration: Yes

Address:
770 WELCH RD
STE 280
PALO ALTO, CA
ZIP 94304
Phone: (650) 347-3426
Get Directions

Jack H Koumjian, DDS is a prosthodontics dentist in Palo Alto, CA. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. Jack H Koumjian, DDS NPI is 1073629390. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

770 WELCH RD
STE 280
PALO ALTO, CA
ZIP 94304-513
Phone: (650) 347-3426
Fax: (650) 324-0103

The NPI 1073629390 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/21/2006 and was last updated on 12/20/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0700X	Dentist	Prosthodontics	327301	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DS0327301	MEDICARE PIN	CALIFORNIA
2	1073629390	OTHER	CALIFORNIA	DENTICAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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