Healthcare Provider Details

I. General information

NPI: 1255390076
Provider Name (Legal Business Name): JANET DECLET D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 NAGLEE RD STE 150
TRACY CA
95304-7339
US

IV. Provider business mailing address

843 SADDLEBACK CT
TRACY CA
95376-8730
US

V. Phone/Fax

Practice location:
  • Phone: 209-830-9100
  • Fax: 209-221-0022
Mailing address:
  • Phone: 727-469-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDN15282
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number64332
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: