Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Daniel Scott Tiedeman, OD

Individual provider Optometrist · NPI 1508986704

Daniel Scott Tiedeman, OD is an Optometry in Elk Grove, California. Qualified in 2004, 22 years ago. Practices with Dignity Health Medical Foundation, a 1,204-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
22
Licensed in
CA
In the registry since
2007
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

9394 Big Horn Blvd
Elk Grove, CA 95758-7977
Phone: (916) 691-8500
Fax: (916) 691-8589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 12657 (CA)

Record details

NPI number1508986704
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedMarch 30, 2007
Last updated in NPPESDecember 8, 2023
Certification dateDecember 8, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Dignity Health Medical Foundation — 1204 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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