Individual provider Active NPI

Adam Joseph Janette, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Luis Obispo, CA
National Provider Identifier
1104877380
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
44324 Issued in CA
Practice address
77 Casa St
Suite 101
San Luis Obispo, CA 93405-5803
Phone
(805) 541-5611
Fax
(805) 541-2328
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 44324 CA Primary

Addresses

Primary practice location

77 Casa St
Suite 101
San Luis Obispo, CA 93405-5803

Mailing address

77 Casa St
Suite 101
San Luis Obispo, CA 93405-5803
Phone (805) 541-5611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 14, 2013 through Jun 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44324CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam J. Janette, DDS Inc. Oral and Maxillofacial Surgery Past Accepting new patients
West Michigan Oral and Maxillofacial Surgery PC Oral and Maxillofacial Surgery PastSince Jul 1, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104877380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "address_2": "SUITE 101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-541-5611",
            "fax_number": "805-541-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "address_2": "SUITE 101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-541-5611",
            "fax_number": "805-541-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANETTE",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "44324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.