DR. TRACEY JEAN DELLAVECCHIA (NPI# 1205802303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205802303 |
| Entity Type | Individual |
| Full Name | DR. TRACEY JEAN DELLAVECCHIA |
| Other Name | DR. TRACEY JEAN LEE |
| Credential | D.D.S. |
| Practice Address |
430 130th Ave Douglas MI 49406-5100 |
| Mailing Address |
Po Box 109 Douglas MI 49406-0109 |
| Practice Telephone | 2698571431 |
| Practice Fax Number | 2698574089 |
| Mailing Telephone | 2698571431 |
| Mailing Fax Number | 2698574089 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2009-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2901018649 | MI | Dental Providers |
| Street Address |
430 130TH AVE |
| City | DOUGLAS |
| State | MI |
| Zip Code | 49406-5100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982836714 | Dellavecchia Dental Services, P.C. | Clinic/Center | 430 130th Ave, Douglas, MI 49406-5100 | 2009-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679657407 | Martin George Raebel II | Dentist | 430 Wiley Road, Douglas, MI 49406 | 2006-10-25 |
| 1629185459 | Nicole Boxer, Md, PC | Family Medicine | 2993 Blue Star Hwy, Suite 102, Douglas, MI 49406 | 2006-08-25 |
| 1942478706 | John Richard Shack | Psychologist | 713 Wilderness Dr., Douglas, MI 49406-0140 | 2008-02-14 |
| 1588650543 | Nanmax Health Management Inc | Skilled Nursing Facility | 243 Wiley Road, Douglas, MI 49406-0217 | 2005-09-26 |
| 1043270390 | Richard C. Annis IIi | Optometrist | 114 Blue Star Highway, Douglas, MI 49406-0280 | 2006-03-23 |
| 1053583476 | Richard C Annis Od PC | Optometrist | 114 Blue Star Highway, Douglas, MI 49406-0280 | 2008-03-26 |
| 1770708372 | A. Joseph Hoski | Orthopaedic Surgery | 177 St. Peter's Drive, Douglas, MI 49406-1027 | 2007-04-17 |
| 1750932125 | Ruth Ann Vanden Bosch | Counselor | 346 Mariners Cove, 30 D, 30 D, Douglas, MI 49406-4940 | 2019-09-26 |
| 1760652853 | Douglas Investments & Associates, LLC | Skilled Nursing Facility | 243 Wiley Rd, Douglas, MI 49406-5108 | 2008-03-05 |
| 1164908976 | Erica J Monroe | Speech-Language Pathologist | 243 Wiley Rd, Douglas, MI 49406-5108 | 2018-07-15 |
| Find all providers in zip 49406 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861050379 | Benjamin Paul Kairis | Dentist | 430 Wiley Rd, Douglas, MI 49406-5122 | 2019-05-30 |
| 1710304399 | A Keeler Family Dental, LLC | Dentist | 1010 E Richards Street, Douglas, WY 82633 | 2014-03-21 |
| 1366606519 | Justin Mcgovern | Dentist | 1370 Gordon St W, Douglas, GA 31533-3432 | 2008-07-16 |
| 1134253727 | Jinnie S Cleveland | Dentist | 1310 Ocilla Rd, Douglas, GA 31533-2222 | 2007-03-15 |
| 1649301102 | Kristine L. Gomez | Dentist | 720 E 11th St, Douglas, AZ 85607-2241 | 2007-03-08 |
| 1932110103 | Heidi Knight White | Dentist | 709 Peterson Ave N, Douglas, GA 31533-4911 | 2006-08-11 |
| 1457331027 | David Allen Vickers | Dentist | 908 Madison Ave N, Douglas, GA 31533-3126 | 2006-01-19 |
| 1972128932 | Jessilee Gabrielle Brooker | Dentist | 1108 Madison Ave N, Douglas, GA 31533-2802 | 2020-06-15 |
| 1891347142 | Luca Tedesco | Dentist | 430 Wiley Rd, Douglas, MI 49406-5122 | 2019-07-16 |
| 1497131510 | Christopher Rogowski | Dentist | 1100 F Ave, Douglas, AZ 85607-1919 | 2015-07-31 |
| Find all providers in DOUGLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.