Garrett Dacker, D.D.S., M.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

100132 Issued in CA

Practice address

613 N Azusa Ave Ste a
Azusa, CA 91702-2968

Phone

(626) 633-0066

NPI assigned

Jun 7, 2016

Last updated

Feb 4, 2019By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Garrett Dacker DDS Inc

  dba SoCal Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Azusa, CA
  • NPI 1649738980
  NPD (past) Authorized official

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1891144184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 N AZUSA AVE STE A",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022968",
            "telephone_number": "626-789-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 N AZUSA AVE STE A",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022968",
            "telephone_number": "626-633-0066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 W Merced Ave",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917904901",
            "country_code": "US",
            "telephone_number": "626-789-5509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACKER",
        "first_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "100132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Harold Cox
• Michael Edwin Cramer
• Markesha Cummings
• Johanna Paula Custodio
• Rachelle Cyrus, M.S., ATC, SFMA, CES
• Danny Dang
• Jocelyn Lizen Davey
• Ashley Nicole Day
• Dion Daniel De Haro, LCSW
• Victor Octavio De Leon, MS, BCBA

• Orthodontics and Dentofacial Orthopedics Dentistry in Azusa, CA
• Providers in Azusa, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.

Verify at the official NPI Registry.