INGERSOLL PARK MARINA GP DENTAL CORPORATION (NPI# 1316547524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316547524 |
| Entity Type | Organization |
| Organization Name | INGERSOLL PARK MARINA GP DENTAL CORPORATION |
| Practice Address |
2301 Park Marina Dr Ste 27 Redding CA 96001-2158 |
| Mailing Address |
3300 N Triumph Blvd Ste 100 Lehi UT 84043-5046 |
| Practice Telephone | 8014944949 |
| Mailing Telephone | 8014944949 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | DR. ANDREK JEFFREY INGERSOLL (MANAGER) |
| Authorized Official Telephone | 9196563004 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Riverbend Family Dental | Doing Business As Name - Organization |
| Street Address |
2301 PARK MARINA DR STE 27 |
| City | REDDING |
| State | CA |
| Zip Code | 96001-2158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528668746 | Ingersoll Park Marina Ped Dental Corporation | Dentist | 2301 Park Marina Dr Ste 27, Redding, CA 96001-2158 | 2020-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651266 | Vanessa Louise Banda | Social Worker | 1544 Magnolia Avenue, Redding, CA 96001 | 2018-12-21 |
| 1184194672 | Marie Sherrick | Licensed Vocational Nurse | 2030 Elreno Lane, Redding, CA 96001 | 2018-11-28 |
| 1699257857 | Prorehab Physical Therapy and Sports Performance, Inc | Physical Therapist | 3673 Eureka Way, Redding, CA 96001 | 2018-09-05 |
| 1316456833 | Jennifer Rose Goehring | Counselor | 1310 Continental Street, Redding, CA 96001 | 2017-09-27 |
| 1891224440 | Audrey Cutler | Social Worker | 1313 Yuba St., Redding, CA 96001 | 2017-06-07 |
| 1184167991 | Calafia Holdings LLC | Skilled Nursing Facility | 1836 Gold Street, Redding, CA 96001 | 2016-11-28 |
| 1194272369 | Shasta County | Clinic/Center | 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 | 2016-09-06 |
| 1417329236 | Shari Hayden | Specialist/Technologist, Other | 2111 Air Park Dr, Redding, CA 96001 | 2015-10-21 |
| 1679951982 | Shasta Hearing Aids | Health Maintenance Organization | 900 Butte St, Redding, CA 96001 | 2015-05-07 |
| 1073919171 | Native American Mental Health Services Corporation | Psychiatry & Neurology | 1742 Oregon Street, Redding, CA 96001 | 2014-11-17 |
| Find all providers in zip 96001 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225635147 | Yat T. Tang, Dds, Ms, Phd, Inc. | Clinic/Center | 3550 Eureka Way Ste 1, Redding, CA 96001-0157 | 2020-10-04 |
| 1467937367 | Quailhearst Corp | Clinic/Center | 2775 Park Marina Dr Ste A, Redding, CA 96001-2840 | 2018-09-27 |
| 1578160339 | Mark P. Lewis, Dds, Inc | Clinic/Center | 3855 Churn Creek Rd, Redding, CA 96002-3229 | 2020-10-05 |
| 1053928911 | Han Anesthesiology | Clinic/Center | 2 Long Ridge Rd, Redding, CT 06896-1111 | 2020-09-24 |
| 1104450956 | Bethany Sr Pllc | Clinic/Center | 2 Long Ridge Rd, Redding, CT 06896-1111 | 2020-03-01 |
| 1205328291 | Shannika Dao Dds Inc. | Clinic/Center | 2695 Bechelli Ln, Redding, CA 96002 | 2018-06-05 |
| 1437573151 | Terrance A. Rust Dds, Inc | Clinic/Center | 2315 Bechelli Ln, Suite A, Redding, CA 96002-0119 | 2014-02-17 |
| 1073875852 | Marty R. Lipsey, Dds, Ms, Inc | Clinic/Center | 2421 Hartnell Ave, Redding, CA 96002-2340 | 2012-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093551 | Arshdeep Kaur Dental Corporation | Clinic/Center | 345 F St Ste 180, Chula Vista, CA 91910-2648 | 2020-11-08 |
| 1699376350 | Funto Ayanleke Dds | Clinic/Center | 1116 W Tokay St Ste A, Lodi, CA 95240-3852 | 2020-11-07 |
| 1427658541 | Anthony Ngo, Dmd Professional Corporation | Clinic/Center | 18361 Beach Blvd, Huntington Beach, CA 92648-1310 | 2020-10-28 |
| 1912507948 | Alexander Phillips Dds Inc | Clinic/Center | 120 C Ave Ste 100, Coronado, CA 92118-1992 | 2020-10-28 |
| 1912507203 | George K Nguyen Dds, PC | Clinic/Center | 2097 Compton Ave Ste 104, Corona, CA 92881-7289 | 2020-10-27 |
| 1396344073 | Charles Kim Dental Corporation | Clinic/Center | 15651 Imperial Hwy Ste 204, La Mirada, CA 90638-1653 | 2020-10-22 |
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1760081129 | Anthony Pham Dental Corp | Clinic/Center | 2658 E Garvey Ave S, West Covina, CA 91791-2113 | 2020-10-17 |
| 1215535182 | Park and Park Dental Group Partnership | Clinic/Center | 473 E Alessandro Blvd Ste A, Riverside, CA 92508-6021 | 2020-10-13 |
| 1013515196 | Bayrakdarian Tulare, D.m.d., Inc., A Professional Corporation | Clinic/Center | 1450 E Prosperity Ave, Tulare, CA 93274-8054 | 2020-10-12 |
| Find all providers with the same taxonomy | ||||
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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.