WENDY J CARVAJAL (NPI# 1740587229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740587229 |
| Entity Type | Individual |
| Full Name | WENDY J CARVAJAL |
| Credential | DDS |
| Practice Address |
205 South St Fort Bragg CA 95437-5540 |
| Mailing Address |
2805 Carradale Dr Roseville CA 95661-4047 |
| Practice Telephone | 7079641251 |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2019-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 60168 | CA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2805 Carradale Dr, Roseville, CA 956614047 | 9166776386 |
| Street Address |
205 SOUTH ST |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508861782 | Wade Joseph Gray | Family Medicine | 205 South St, Fort Bragg, CA 95437-5540 | 2005-06-15 |
| 1477046027 | Roy Campbell | Dental Hygienist | 205 South St, Fort Bragg, CA 95437-5540 | 2018-06-08 |
| 1457861783 | Andrea Masters | Nurse Practitioner | 205 South St, Fort Bragg, CA 95437-5540 | 2017-09-29 |
| 1437501566 | Jae Do Kim | Dentist | 205 South St, Fort Bragg, CA 95437-5540 | 2016-07-13 |
| 1558790774 | Nadege Nerette | Physician Assistant | 205 South St, Fort Bragg, CA 95437-5540 | 2013-11-07 |
| 1932532272 | Svetlana Romanovna Mulcahy | Nurse Practitioner | 205 South St, Fort Bragg, CA 95437-5540 | 2013-08-09 |
| 1013257831 | Kimberly Jill Celeri | Dental Hygienist | 205 South St, Fort Bragg, CA 95437-5540 | 2013-02-15 |
| 1821340480 | Genevieve Marilyn Gonzalez | Counselor | 205 South St, Fort Bragg, CA 95437 | 2012-10-08 |
| 1447500988 | Ted Michael Aames | Counselor | 205 South St, Fort Bragg, CA 95437-5540 | 2012-09-12 |
| 1073841540 | Lynne Barbara Bornheim | Social Worker | 205 South St, Fort Bragg, CA 95437 | 2009-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700498631 | Jaclyn Jennifer Willis | Dentist | Ardennes Street, Fort Bragg, NC 28307 | 2020-08-21 |
| 1487265039 | John Michael Mckelvey Jr. | Dentist | 6238 Ardennes St, Fort Bragg, NC 28310-0001 | 2020-08-16 |
| 1447805254 | Ross Carroll | Dentist | 1700 Goldberg St, Fort Bragg, NC 28310-0001 | 2019-08-08 |
| 1003398850 | Bailey Moorhead | Dentist | Bldg C-6238 Ardennes Road, Fort Bragg, NC 28307 | 2018-08-29 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1528546322 | Michael J Rethman | Dentist | Bldg M4861 Logistics Avenue Joel Dental Clinic, Fort Bragg, NC 28310-7302 | 2018-08-02 |
| 1245749324 | Michael Stewart Almony | Dentist | Bldg C-6238 Ardennes St, Fort Bragg, NC 28310-0001 | 2017-09-21 |
| 1609392034 | Elliot James Devinney | Dentist | Usa Dental Activity, Attn: Mcds Na B, Bldg 6837 Normandy Drive, Fort Bragg, NC 28310-7302 | 2017-08-17 |
| 1093231425 | Walter Garwood Hinman V | Dentist | Bldg 6837 Normandy Drive Attn: Mcds Na B, Fort Bragg, NC 28310-0001 | 2017-08-17 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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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.