Garrett Dacker DDS Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

GARRETT DACKER DDS INC

Doing business as

SoCal Orthodontics

Practice address

613 N Azusa Ave Ste a
Azusa, CA 91702-2968

Phone

(626) 633-0066

NPI assigned

Mar 6, 2019

Last updated

Mar 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Garrett Dacker, DDS, MDSNPI 1891144184

Title

President

Phone

(626) 484-0075

Specialties & licenses 1

Addresses

Other names 1

• SoCal Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Garrett Dacker, D.D.S., M.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Azusa, CA
  • NPI 1891144184
  NPD (past) Authorized official

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1649738980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 PEBBLE SPRINGS LN",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 N AZUSA AVE STE A",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022968",
            "telephone_number": "626-633-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARRETT DACKER DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "DACKER",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-484-0075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoCal Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Azusa, CA
• Providers in Azusa, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.