Individual provider Active NPI

David Vergil Fischer, D.D.S.

  • General Practice Dentistry
  • Grass Valley, CA
National Provider Identifier
1316199078
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
102870 Issued in CA
Practice address
463 Sutton Way
Grass Valley, CA 95945-4102
Phone
(530) 273-1470
Fax
(165) 864-9109
NPI assigned
Oct 14, 2008
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 102870 CA Primary

Addresses

Primary practice location

463 Sutton Way
Grass Valley, CA 95945-4102

Mailing address

13664 Rockway PL
Nevada City, CA 95959-9272
Phone (165) 864-9109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102870CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet Dreams Ut LLC General Practice PastSince Dec 10, 2023 Accepting new patients
Fore Dental a Professional Corporation PastSince Oct 27, 2024 Accepting new patients
Nelson D. Glassett LLC General Practice Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1316199078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13664 ROCKWAY PL",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959599272",
            "telephone_number": "165-864-9109",
            "fax_number": "165-864-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 SUTTON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454102",
            "telephone_number": "530-273-1470",
            "fax_number": "165-864-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "DAVID",
        "middle_name": "VERGIL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-14",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.