Individual provider Active NPI

Jose David Sanchez, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Tehachapi, CA
National Provider Identifier
1336206788
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
25836 Issued in CA
Practice address
20370 W Valley Blvd
Tehachapi, CA 93561-8615
Phone
(661) 822-3727
Fax
(661) 822-4529
NPI assigned
Jan 3, 2007
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 25836 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 25836 CA Primary

Addresses

Primary practice location

20370 W Valley Blvd
Tehachapi, CA 93561-8615

Mailing address

20370 W Valley Blvd
Tehachapi, CA 93561-8615
Phone (661) 822-3727

Other identifiers 1

IdentifierTypeStateIssuer
CA169056OtherCAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090818000393 CA Practitioner - Oral SurgeryPractitioner - Dentist 0042364507 Practice locations: Tehachapi, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1336206788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20370 W VALLEY BLVD",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618615",
            "telephone_number": "661-822-3727",
            "fax_number": "661-822-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20370 W VALLEY BLVD",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618615",
            "telephone_number": "661-822-3727",
            "fax_number": "661-822-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "JOSE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "25836",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "25836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CA169056",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tehachapi, CA

Sources for this page

Verify at the official NPI Registry.