Individual provider Active NPI

Thomas Richard Bietsch, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Rancho Cucamonga, CA
National Provider Identifier
1396718607
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
46560 Issued in CA
Practice address
7333 Hellman Ave
Rancho Cucamonga, CA 91730-1302
Phone
(909) 987-6205
Fax
(909) 987-8342
NPI assigned
Feb 8, 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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 46560 CA Primary

Addresses

Primary practice location

7333 Hellman Ave
Rancho Cucamonga, CA 91730-1302

Mailing address

7333 Hellman Ave
Rancho Cucamonga, CA 91730-1302
Phone (909) 987-6205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161025002144 TX Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2365720414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46560CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396718607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7333 HELLMAN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301302",
            "telephone_number": "909-987-6205",
            "fax_number": "909-987-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7333 HELLMAN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301302",
            "telephone_number": "909-987-6205",
            "fax_number": "909-987-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIETSCH",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "46560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.