MEDICARE: JOHN E BERTSCH DDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	38494	CA

General Provider Information

NPI Number	:	1679670699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN E BERTSCH DDA

Provider Business Mailing Address
First Line	:	2222 FRANCISCO DR STE 460
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-3780
Country	:	US
Telephone Number	:	916-933-3011
Fax Number	:	916-933-6011

Provider Business Practice Location Address
First Line	:	2222 FRANCISCO DR STE 460
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-3780
Country	:	US
Telephone Number	:	916-933-3011
Fax Number	:	916-933-6011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/15/2026

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Directions to “ JOHN E BERTSCH DDA” Practice Location

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