MEDICARE: DR. JANET DECLET D.M.D.

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	1223D0001X	Public Health Dentistry	DN15282	FL
2	1223G0001X	General Practice Dentistry	64332	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255390076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET DECLET D.M.D.

Provider Business Mailing Address
First Line	:	843 SADDLEBACK CT
Second Line	:
City	:	TRACY
State	:	CA
Zip	:	95376-8730
Country	:	US
Telephone Number	:	727-469-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2805 NAGLEE RD STE 150
Second Line	:
City	:	TRACY
State	:	CA
Zip	:	95304-7339
Country	:	US
Telephone Number	:	209-830-9100
Fax Number	:	209-221-0022

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	05/04/2026

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