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JACK H KOUMJIAN DDS
NPI 1073629390
Dentist - Prosthodontics in Palo Alto, CA

Active since August 21, 2006PECOS Enrolled
770 WELCH RD, STE 280, PALO ALTO, CA 94304(650) 347-3426(650) 324-0103 Get Directions Write a Review

NPPES record last updated: December 20, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack H Koumjian Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK H KOUMJIAN DDS (NPI 1073629390) is an individual prosthodontics provider in Palo Alto, California, licensed in California (327301) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073629390
Entity TypeIndividualMale
Primary Taxonomy1223P0700X
Provider Legal NameJACK H KOUMJIANCredential: DDS
Location Address770 WELCH RD, STE 280Palo Alto, CA 94304-1513
Mailing Address770 Welch Rd, Ste 280Palo Alto, CA 94304-1513 · (650) 347-3426 · Fax (650) 324-0103
Phone(650) 347-3426
Fax(650) 324-0103
Sole ProprietorNo
Enumeration DateAugust 21, 2006
Last NPPES UpdateDecember 20, 2007
✔ NPI 1073629390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers
Taxonomy Code1223P0700X
License✔ Licensed in CA · 327301
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.
770 WELCH RD, Palo Alto, CA 94304
Open in Google Maps ↗

Other Identifiers 2

Medicare PINDS0327301CA
Other1073629390CA · Dentical

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack H Koumjian Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. YUSRA NAZAR HUSSAIN M.D.
Internal Medicine (Geriatric Medicine)
770 WELCH RD, SUITE # 250
PALO ALTO, CA 94304
Santa Clara County (650) 328-1676
SHELLEY AGGARWAL MD
Pediatrics (Adolescent Medicine)
770 WELCH RD, DIVISION OF ADOLESCENT MEDICINE
PALO ALTO, CA 94304
Santa Clara County (650) 736-9557
DR. JENNIFER LEE HWANG DUDA MD
Pediatrics (Pediatric Hematology-Oncology)
770 WELCH RD, SUITE 261
PALO ALTO, CA 94304
Santa Clara County (650) 497-8953
CARMEN AGUILAR MANDAC NP
Nurse Practitioner
770 WELCH RD, SUITE 100
PALO ALTO, CA 94304
Santa Clara County (650) 725-8771
DR. SHAWN MOSHREFI M.D.
Student in an Organized Health Care Education/Training Program
770 WELCH RD, DIV OF PLASTIC SURGERY STE 400
PALO ALTO, CA 94304
Santa Clara County (650) 723-5824
ALEXANDER LI
Surgery (Plastic and Reconstructive Surgery)
770 WELCH RD, ATTN: ALEXANDER LI, PLASTIC SURGERY
PALO ALTO, CA 94304
Santa Clara County (650) 723-5824
LUCILE PACKARD CHILDREN'S HOSPITAL
Clinic/Center
770 WELCH RD
PALO ALTO, CA 94304
Santa Clara County (650) 721-2589
ALI SALIM M.D.
Plastic Surgery
770 WELCH RD, SUITE 400 - STANFORD PLASTIC SURGERY
PALO ALTO, CA 94304
Santa Clara County (650) 723-5824

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Koumjian's NPI number?

The NPI number for Jack Koumjian is 1073629390. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is Jack Koumjian located?

Jack Koumjian practices at 770 Welch Rd Ste 280, Palo Alto, CA 94304. The listed phone number is (650) 347-3426.

What is Jack Koumjian's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Is Jack Koumjian enrolled in Medicare?

Yes. Jack Koumjian is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Koumjian was last updated on December 20, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.