David H Deter, D.D.S.
Individual provider Active NPI General Practice Dentistry · La Canada, CA
NPI 1184722340 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184722340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 21111 (CA)
- Practice address
- 1751 Foothill Blvd # 1
La Canada, CA 91011-2950 - Phone
- (818) 952-8991
- Fax
- (818) 952-8995
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective May 4, 2015 through May 4, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21111 | CA | MD | Child & Adolescent Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21111 | CA | Yes |
Addresses
Primary practice location
1751 Foothill Blvd # 1
La Canada, CA 91011-2950
Mailing address
1751 Foothill Blvd # 1
La Canada, CA 91011-2950
Phone (818) 952-8991
Other providers in La Canada, CA
- Francesca Corley
- Belle Starr Cruz
- Russell Michael Dea
- Anahit S Derian
- Descanso Dermatology Medical Group
- Kelly Ethel Diaz
- Jason Edward Dietz
- Joel Doerning
- Drange Hallman Medical Corporation
- DRS. Ho Dental Partnership
All providers in La Canada, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.