Individual provider Active NPI

John Bruce McCleve, DDS

  • General Practice Dentistry
  • Los Gatos, CA
National Provider Identifier
1619079175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45147 Issued in CA
Practice address
751 Blossom Hill Rd
Suite C
Los Gatos, CA 95032-3583
Phone
(408) 356-6650
Fax
(408) 356-8170
NPI assigned
Sep 3, 2006
Sex
Male
Sole proprietor
Yes

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 45147 CA Primary

Addresses

Primary practice location

751 Blossom Hill Rd
Suite C
Los Gatos, CA 95032-3583

Mailing address

361 N 1St St
Apt. 4
Campbell, CA 95008-1330
Phone (408) 674-4357

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 Feb 18, 2016 through Feb 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
45147CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619079175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 N 1ST ST",
            "address_2": "APT. 4",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081330",
            "telephone_number": "408-674-4357",
            "fax_number": "408-356-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 BLOSSOM HILL RD",
            "address_2": "SUITE C",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323583",
            "telephone_number": "408-356-6650",
            "fax_number": "408-356-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLEVE",
        "first_name": "JOHN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.