Krajekian, Jack Issac

Krajekian, Jack Issac is an individual health care provider with primary practice located at 1215 Virginia St E , Charleston WV 25301-2908. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Krajekian, Jack Issac can be contacted via phone (304) 345-1092.

Contact Information

Primary practice address
1215 Virginia St E Charleston WV 25301-2908
Phone: (304) 345-1092
Fax: (304) 345-1095
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3542 West Virginia
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 116 West Virginia
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DS036241 Pennsylvania
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 19714 Massachusetts

Profile Details

NPI number 1790768562
LBN Legal business name Krajekian, Jack Issac
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790768562 NPPES
West Virginia MEDICAID 4002152000

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