John Sloane Noe, DDS
Individual provider Active NPI Dentist · Walnut Grove, CA
NPI 1013016492 · NPPES record last updated Aug 4, 2008
Key facts
- NPI
- 1013016492
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 42203 (CA)
- Practice address
- 14137 Tyler Street
Walnut Grove, CA 95690 - Phone
- (916) 776-2131
- Fax
- (916) 776-2135
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42203 | CA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 42203 | CA | Yes |
Addresses
Primary practice location
14137 Tyler Street
Walnut Grove, CA 95690
Mailing address
PO Box 1049
Walnut Grove, CA 95690-1049
Phone (916) 776-2131
Other providers in Walnut Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.