Provider Demographics
NPI:1598995060
Name:BAJUSCAK, JASON AARON (DMD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:AARON
Last Name:BAJUSCAK
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30045 SW PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9735
Mailing Address - Country:US
Mailing Address - Phone:503-682-2455
Mailing Address - Fax:503-570-8852
Practice Address - Street 1:30045 SW PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-9735
Practice Address - Country:US
Practice Address - Phone:503-682-2455
Practice Address - Fax:503-570-8852
Is Sole Proprietor?:No
Enumeration Date:2009-07-19
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9298122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist