Individual provider Active NPI

Brian S Orcutt, DDS

  • General Practice Dentistry
  • Fair Oaks, CA
National Provider Identifier
1720205834
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52905 Issued in CA
Practice address
7840 Madison Avenue Suite 185
Fair Oaks, CA 95628-3518
Phone
(916) 963-9986
Fax
(916) 961-8433
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 52905 CA Primary

Addresses

Primary practice location

7840 Madison Avenue Suite 185
Fair Oaks, CA 95628-3518

Mailing address

7840 Madison Avenue Suite 185
Fair Oaks, CA 95628-3518
Phone (916) 963-9986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160126000615 CA Order and Referring Only - DentistPractitioner - Dentist 5294038287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52905CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orcutt Family Dentistry General Practice CurrentSince Jul 1, 2024 Accepting new patients

Locations

7840 Madison Ave
Ste 185
Fair Oaks, CA 95628
Phone (916) 963-9986

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1720205834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7840 MADISON AVENUE SUITE 185",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283518",
            "telephone_number": "916-963-9986",
            "fax_number": "916-961-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 MADISON AVENUE SUITE 185",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283518",
            "telephone_number": "916-963-9986",
            "fax_number": "916-961-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORCUTT",
        "first_name": "BRIAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

Verify at the official NPI Registry.