Active NPI
Daniel Joseph Tatich, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Moundsville, WV
National Provider Identifier
1790868248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 3504
- Practice address
- 200 Teletech Drive
Suite B
Moundsville, WV 26041 - Phone
- (304) 845-4848
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 3504 | WV | Primary |
Addresses
Primary practice location
200 Teletech Drive
Suite B
Moundsville, WV 26041
Mailing address
200 Teletech Drive
Suite B
Moundsville, WV 26041
Phone (304) 845-4848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150824000215 | WV | Order and Referring Only - Maxillofacial Surgery | 6800895210 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3504 | WV | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186099200000",
"number": "1790868248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 TELETECH DRIVE",
"address_2": "SUITE B",
"city": "MOUNDSVILLE",
"state": "WV",
"postal_code": "26041",
"telephone_number": "304-845-4848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TELETECH DRIVE",
"address_2": "SUITE B",
"city": "MOUNDSVILLE",
"state": "WV",
"postal_code": "26041",
"telephone_number": "304-845-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATICH",
"first_name": "DANIEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2007-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "WV",
"license": "3504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moundsville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.