Active NPI
Thomas Adam Jarrett, D.D.S.
- Dentist
- South Lake Tahoe, CA
National Provider Identifier
1831239904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 42160
- Practice address
- 965 Tahoe Keys Blvd
South Lake Tahoe, CA 96150-7140 - Phone
- (530) 541-4405
- Fax
- (530) 541-5528
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 42160 | CA | Primary |
Addresses
Primary practice location
965 Tahoe Keys Blvd
South Lake Tahoe, CA 96150-7140
Mailing address
965 Tahoe Keys Blvd
South Lake Tahoe, CA 96150-7140
Phone (530) 541-4405
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective May 13, 2015 through May 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831239904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 TAHOE KEYS BLVD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507140",
"telephone_number": "530-541-4405",
"fax_number": "530-541-5528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 TAHOE KEYS BLVD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507140",
"telephone_number": "530-541-4405",
"fax_number": "530-541-5528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARRETT",
"first_name": "THOMAS",
"middle_name": "ADAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "42160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
Sources for this page
- 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.