JACK H KOUMJIAN


Address: 770 Welch Rd, Ste 280, Palo Alto, CA 94304-1513
Phone: 6503473426

JACK H KOUMJIAN (NPI# 1073629390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073629390
Entity Type Individual
Full Name JACK H KOUMJIAN
Credential DDS
Practice Address 770 Welch Rd
Ste 280
Palo Alto
CA 94304-1513
Practice Telephone 6503473426
Practice Fax Number 6503240103
Mailing Telephone 6503473426
Mailing Fax Number 6503240103
Enumeration Date 2006-08-21
Last Update Date 2007-12-20
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0700X Dentist
Specialization: Prosthodontics
327301 CA Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA DENTICAL 1073629390 01

Office Location

Street Address 770 WELCH RD
STE 280
City PALO ALTO
State CA
Zip Code 94304-1513

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326009572 Gordon K. Lee Surgery 770 Welch Rd, Suite 400, Mailcode 5715, Palo Alto, CA 94304-1511 2006-03-29
1558978643 Mayra Flores Nurse Practitioner 770 Welch Rd, Palo Alto, CA 94304-1511 2020-09-23
1730693037 Emily Cummings Hardy Midwife 770 Welch Rd, Palo Alto, CA 94304-1511 2017-11-22
1801316153 Laurel Kathleen Back Kent Nurse Practitioner 770 Welch Rd, Palo Alto, CA 94304-1511 2017-06-27
1184151573 Lucile Packard Children's Hospital General Acute Care Hospital 770 Welch Rd, Palo Alto, CA 94304-1511 2017-05-16
1144753898 Alexander Li Student in an Organized Health Care Education/Training Program 770 Welch Rd, Attn: Alexander Li, Plastic Surgery, Palo Alto, CA 94304-1511 2017-04-10
1477907665 Janos Barrera Student in an Organized Health Care Education/Training Program 770 Welch Rd, Palo Alto, CA 94304-1511 2016-04-14
1750735999 Anna Zhou Student in an Organized Health Care Education/Training Program 770 Welch Rd, Suite 400, Palo Alto, CA 94304-1511 2016-04-13
1174907083 Zeshaan Maan Surgery 770 Welch Rd, 4th Floor, Plastic Surgery Office, Palo Alto, CA 94304-1511 2015-07-10
1437546561 Travis Joseph Miller Student in an Organized Health Care Education/Training Program 770 Welch Rd, Suite 400, Palo Alto, CA 94304-1511 2015-04-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477170611 Richard Engdahl Specialist/Technologist, Other 820 Quarry Road, Mc1078 Hf006, Palo Alo, CA 94304 2020-07-04
1720603582 Lily Wenya Zhou Psychiatry & Neurology 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 2020-06-08
1033738521 Perry Seo Choi Student in an Organized Health Care Education/Training Program Dept of Cardiothoracic Surgery, Falk Building, 870 Quarry Rd, Palo Alto, CA 94304 2020-04-14
1073150355 Tara Mcdermott Nurse Practitioner 500 Pasteur Drive, Cardiovascular Intensive Care Unit, Palo Alto, CA 94304 2019-12-05
1811542723 Mark Henry Chubb Pediatrics Stanford Children's Health, 725 Welch Road, Palo Alto, CA 94304 2019-08-07
1194285114 Cora Steindl Nurse Practitioner 300 Pasteur Drive Rm H2512, Stanford, CA 94304 2019-03-25
1407333057 Deborah Menet Landi Social Worker Lucile Packard Children's Hospital Stanford, 725 Welch, Mc 5933, Palo Alto, CA 94304 2018-07-26
1982100798 Jonathan Hootman Student in an Organized Health Care Education/Training Program 900 Quarry Road Extension, Palo Alto, CA 94304 2018-04-02
1093234254 Adam C Maclellan Psychiatry & Neurology Stanford Stroke Center, 780 Welch Road, Suite 350, Palo Alto, CA 94304 2017-09-19
1194248153 Chanel Beaudoin Cloutier Plastic Surgery 770 Welch Road, Suite 400, Palo Alto, CA 94304 2017-07-21
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Taxonomy Information

Taxonomy Code 1223P0700X
Grouping Dental Providers
Classification Dentist
Specialization Prosthodontics

Taxonomy Definition

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.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144661075 Andrea Elizabeth Jordan Dentist 1691 El Camino Real, Suite 200, Palo Alto, CA 94306-1053 2013-07-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1952902272 Prajna Banan Dentist 10833 Le Conte Ave Rm A0-156a, Los Angeles, CA 90095-3075 2020-11-03
1780299891 Craig W. Conrow Dds Ms Inc Dentist 73993 Highway 111 Ste 200, Palm Desert, CA 92260-4034 2020-09-15
1750995601 Maggie T. Chao A Professional Corporation Dentist 1475 Cedarwood Ln Ste C, Pleasanton, CA 94566-6128 2020-09-08
1447881123 Setia Dental Corporation Dentist 1130 Folsom St, San Francisco, CA 94103-3928 2020-01-30
1780239954 Rishabh Pravin Acharya Dentist 707 Parnassus Avenue, D-4000, San Francisco, CA 94143 2019-08-05
1295395796 Pleasant Hill Prosthodontics Dentist 401 Gregory Ln Ste 130, Pleasant Hill, CA 94523-2836 2019-06-17
1346706363 Todd M Yonemura Dds, Apc Dentist 400 El Cerro Blvd., Suite #103, Danville, CA 94526 2019-02-14
1457834889 William Ginzburg Dental Center Inc Dentist 13286 Fiji Way, Marina Del Rey, CA 90292-7119 2018-09-12
1528549730 Alison Fishman Dentist 160 Bovet Rd Ste 307, San Mateo, CA 94402-3138 2018-08-25
1912483389 Edmond Armand Bedrossian Dentist 450 Sutter St Rm 2618, San Francisco, CA 94108-4205 2018-07-18
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Competitor

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City PALO ALTO
Zip Code 94304

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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