NPIMap

Organization Active NPI

John C. Trueb, DDS, Inc.

  • Dental Clinic/Center
  • Manteca, CA
National Provider Identifier
1053964072
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
JOHN C. TRUEB, DDS, INC.
Practice address
165 Saint Dominics Dr Ste 100
Manteca, CA 95337-7802
Phone
(209) 823-3574
Fax
(209) 239-4378
NPI assigned
Jul 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Charles Trueb, DDSNPI 1790794758
Title
Owner
Phone
(209) 823-3574

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

165 Saint Dominics Dr Ste 100
Manteca, CA 95337-7802

Mailing address

165 Saint Dominics Dr Ste 100
Manteca, CA 95337-7802
Phone (209) 823-3574

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1053964072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SAINT DOMINICS DR STE 100",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377802",
            "telephone_number": "209-823-3574",
            "fax_number": "209-239-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 SAINT DOMINICS DR STE 100",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377802",
            "telephone_number": "209-823-3574",
            "fax_number": "209-239-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. TRUEB, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-18",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "TRUEB",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-823-3574",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.