David J Tracy, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

29506 Issued in CA

Practice address

1207 Carlsbad Village Dr Ste a
Carlsbad, CA 92008-1958

Phone

(760) 434-4301

Fax

(760) 434-6016

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 Mar 28, 2016 through Mar 28, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689714263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 CARLSBAD VILLAGE DR STE A",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081958",
            "telephone_number": "760-434-4301",
            "fax_number": "760-434-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 CARLSBAD VILLAGE DR STE A",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081958",
            "telephone_number": "760-434-4301",
            "fax_number": "760-434-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "29506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Torrey Pines Physician Assistant Surgical Services, Inc
• Elmer Ernesto Torrez Venaderos
• Collin Bradley Torsak
• Teresa L Toth
• Julia Tower
• Michael Kennedy Tracy, M.D.
• Patrick Tracy, PHARMD
• Tram Ho Petersen Inc.
• Brandon Tran, DPT
• Chau Nhut Tran

• Oral and Maxillofacial Surgery (Dentist) in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.