Thaddous L Archie, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS30098CA Issued in CA

Practice address

8013 Laguna Blvd Ste 2
Elk Grove, CA 95758-7920

Phone

(916) 691-6020

Fax

(916) 691-6022

NPI assigned

Dec 6, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Thaddous Archie, DDS

  • Dental Clinic/Center
  • Elk Grove, CA
  • NPI 1598588451
  NPD Authorized official

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1992864011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8013 LAGUNA BLVD STE 2",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587920",
            "telephone_number": "916-691-6020",
            "fax_number": "916-691-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8013 LAGUNA BLVD STE 2",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587920",
            "telephone_number": "916-691-6020",
            "fax_number": "916-691-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIE",
        "first_name": "THADDOUS",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS30098CA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Applied Beginnings LLC
• Kaelen Maria Aragon
• Michael Derrick Arca, M.D.
• Kyle Arce-Ignacio
• Inesita Arce
• Victor Andrew Arcineda Jr.
• Andrea Arciniega
• Carla Arellano, MD
• Guillermo A Arellano II, D.M.D.
• Julie Ann Arellano, MD

• General Practice Dentistry in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.