Individual provider Active NPI

John Phillip Tacheff, DDS

  • General Practice Dentistry
  • Escalon, CA
National Provider Identifier
1467550434
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
032909 Issued in CA
Practice address
1302 Mitchell Ave
Escalon, CA 95320
Phone
(209) 838-7191
Fax
(209) 838-8002
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 032909 CA Primary

Addresses

Primary practice location

1302 Mitchell Ave
Escalon, CA 95320

Mailing address

1302 Mitchell Ave
Escalon, CA 95320
Phone (209) 838-7191

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
032909CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467550434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 MITCHELL AVE",
            "city": "ESCALON",
            "state": "CA",
            "postal_code": "95320",
            "telephone_number": "209-838-7191",
            "fax_number": "209-838-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 MITCHELL AVE",
            "city": "ESCALON",
            "state": "CA",
            "postal_code": "95320",
            "telephone_number": "209-838-7191",
            "fax_number": "209-838-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACHEFF",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "032909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escalon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.