Michael John Doucet, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

35099 Issued in CA

Practice address

419 San Pablo Ave
Albany, CA 94706

Phone

(510) 526-8000

Fax

(510) 526-5114

NPI assigned

Sep 27, 2006

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

Other identifiers 1

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 Jul 27, 2016 through Jul 27, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• A Khalil DDS Apc

  • Oral and Maxillofacial Surgery (Dentist)
  • Albany, CA
  • NPI 1992269799

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1760573307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "94706",
            "telephone_number": "510-526-8000",
            "fax_number": "510-526-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "94706",
            "telephone_number": "510-526-8000",
            "fax_number": "510-526-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUCET",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "35099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B35099-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana Delgado
• Gerard Dericks, MD
• Anne C. Dinkelspiel, PH.D.
• Andrew Doan, D.M.D.
• Margaret Dodson, PH.D.
• Dr. Shufang Tsai Psychologist, Inc
• Carol Drucker
• Cody Dunitz
• Martha E Durell
• Annie Dutka, PSYD

• Oral and Maxillofacial Surgery (Dentist) in Albany, CA
• Providers in Albany, 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 Jan 7, 2011; 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.