Individual provider Active NPI

Donald Bruce McEtchin, DDS

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1548254824
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29082 Issued in CA
Practice address
3309 Lakeshore Ave
Oakland, CA 94610-2305
Phone
(510) 444-4331
Fax
(510) 444-4331
NPI assigned
Sep 1, 2005
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
General Practice Dentistry 1223G0001X 29082 CA Primary

Addresses

Primary practice location

3309 Lakeshore Ave
Oakland, CA 94610-2305

Mailing address

3309 Lakeshore Ave
Oakland, CA 94610-2305
Phone (510) 444-4331

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

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1548254824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 LAKESHORE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102305",
            "telephone_number": "510-444-4331",
            "fax_number": "510-444-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 LAKESHORE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102305",
            "telephone_number": "510-444-4331",
            "fax_number": "510-444-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCETCHIN",
        "first_name": "DONALD",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.