MRS. TRACY SISE (NPI# 1477694628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477694628 |
| Entity Type | Individual |
| Full Name | MRS. TRACY SISE |
| Credential | COSA |
| Practice Address |
1213 Coffee Rd Ste D Modesto CA 95355-4229 |
| Practice Telephone | 2095225238 |
| Practice Fax Number | 2095224703 |
| Mailing Telephone | 2095225238 |
| Mailing Fax Number | 2095224703 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | Dental Providers |
| Street Address |
1213 COFFEE RD STE D |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-4229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679613327 | Kathleen D Wright | Dental Assistant | 1213 Coffee Rd Ste D, Modesto, CA 95355-4229 | 2007-02-08 |
| 1053974196 | Brian K. Hutto, Dmd, Inc. | Clinic/Center | 1213 Coffee Rd Ste D, Modesto, CA 95355-4229 | 2019-04-15 |
| 1275674434 | Krystal Lane | Dental Assistant | 1213 Coffee Rd Ste D, Modesto, CA 95355-4229 | 2007-02-09 |
| 1033250287 | Angelica Cruz | Dental Assistant | 1213 Coffee Rd Ste D, Modesto, CA 95355-4229 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
| Find all providers in zip 95355 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801324108 | Elizabeth Ramirez | Dental Assistant | 201 E Orangeburg Ave Ste A, Modesto, CA 95350-5355 | 2017-05-31 |
| 1679613327 | Kathleen D Wright | Dental Assistant | 1213 Coffee Rd Ste D, Modesto, CA 95355-4229 | 2007-02-08 |
| 1508917675 | April N Nelson-ehlers | Dental Assistant | 1316 Coffee Rd Ste E14, Dr Roland Young, Modesto, CA 95355 | 2007-01-16 |
| 1083774285 | Stacie Anne Elson | Dental Assistant | 1130 Coffee Rd Ste 9a, Modesto, CA 95355-4228 | 2006-12-11 |
| 1801306493 | Jennifer K Azevedo | Dental Assistant | 201 E Orangeburg Ave Ste A, Modesto, CA 95350-5355 | 2017-10-09 |
| 1477887628 | Mirna Metcalf | Dental Assistant | 1316 Coffee Rd, Bldg E, Modesto, CA 95355-3191 | 2009-09-21 |
| 1306170568 | Merissa Renee Apodaca | Dental Assistant | 1316 Coffee Rd Ste E14, Modesto, CA 95355-3191 | 2009-09-21 |
| 1275674434 | Krystal Lane | Dental Assistant | 1213 Coffee Rd Ste D, Modesto, CA 95355-4229 | 2007-02-09 |
| 1033250287 | Angelica Cruz | Dental Assistant | 1213 Coffee Rd Ste D, Modesto, CA 95355-4229 | 2007-02-09 |
| 1669560082 | Shelby Adrienne Thompson | Dental Assistant | 1316 Coffee Rd, Suite E14, Modesto, CA 95355-3191 | 2006-10-11 |
| Find all providers in MODESTO | ||||
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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.