Individual provider Active NPI

Joyce M Litch, DDS MSD

  • Periodontics
  • Campbell, CA
National Provider Identifier
1366531378
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
34732 Issued in CA
Practice address
2160 S Bascom Ave
#1
Campbell, CA 95008-3294
Phone
(408) 371-7616
Fax
(408) 371-7651
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 34732 CA Primary

Addresses

Primary practice location

2160 S Bascom Ave
#1
Campbell, CA 95008-3294

Mailing address

2160 S Bascom Ave
1
Campbell, CA 95008-3297
Phone (408) 371-7616

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 Sep 17, 2018 through Sep 17, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34732CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy K Ueno DMD a Professional Corporation PastSince Aug 1, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1366531378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S BASCOM AVE",
            "address_2": "1",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950083297",
            "telephone_number": "408-371-7616",
            "fax_number": "408-371-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S BASCOM AVE",
            "address_2": "#1",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950083294",
            "telephone_number": "408-371-7616",
            "fax_number": "408-371-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITCH",
        "first_name": "JOYCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "34732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.