CHAD J. ANDERSON DENTAL CORPORATION (NPI# 1780061879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780061879 |
| Entity Type | Organization |
| Organization Name | CHAD J. ANDERSON DENTAL CORPORATION |
| Practice Address |
5084 N Fruit Ave Ste 101 Fresno CA 93711-3000 |
| Mailing Address |
9497 N Fort Washington Rd Ste 106 Fresno CA 93730-0606 |
| Practice Telephone | 5592263686 |
| Practice Fax Number | 5592260947 |
| Mailing Telephone | 5594341096 |
| Mailing Fax Number | 5594341799 |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |
| Authorized Official Name | CHAD JASON ANDERSON (OWNER) |
| Authorized Official Telephone | 5594341096 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | Y |
| Parent Organization Name | CHAD J. ANDERSON DENTAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 52822 | CA | Dental Providers |
| Street Address |
5084 N FRUIT AVE STE 101 |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-3000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720186810 | George T King | Dentist | 5084 N Fruit Ave Ste 101, Fresno, CA 93711-3000 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104464684 | Kazi Shafiul Moula | Dentist | Western Dental/ Brident 150bfo, 3077 W Shaw Ave, Fresno, CA 93711 | 2019-12-16 |
| 1760037063 | Armine Petrosyan | Nurse Practitioner | 427 W Beford Ave Suite 103, Fresno, CA 93711 | 2019-08-05 |
| 1912489360 | Shoua Nelson | Nurse Practitioner | 2490 W. Shaw Avenue Suite 101, Fresno, CA 93711 | 2018-09-02 |
| 1245725506 | Promesa Behavioral Health-barstow | Community Based Residential Treatment Facility, Mental Illness | 1415 W Barstow Ave, Fresno, CA 93711 | 2018-06-28 |
| 1407344138 | Aidan Mechem | Behavior Technician | 5140 N. Fruit Avene, Fresno, CA 93711 | 2018-04-27 |
| 1841798840 | Michael Ramos IIi | Behavior Technician | 1690 N Shaw Ave, 102, Fresno, CA 93711 | 2018-01-25 |
| 1962913467 | Dhara Devendrakumar Patel | Pharmacist | 740 West Alluvial Avenue, Suite 101, Fresno, CA 93711 | 2017-10-24 |
| 1588183636 | Bianca Arteaga | Counselor | 7485 N. Palm Ave., Suite 103, Fresno, CA 93711 | 2017-09-10 |
| 1346763158 | Powell Pediatric Dentistry Ingram Partnership | Dentist | 7761 N Ingram Ave, Suite 101, Fresno, CA 93711 | 2017-07-24 |
| 1982124202 | Justine Syera Balbas | Counselor | 2766 W. Celeste Ave., Unit 103, Fresno, CA 93711 | 2017-06-27 |
| Find all providers in zip 93711 | ||||
| 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 |
|---|---|---|---|---|
| 1336752971 | Mauricio Rubio | Dentist | 5336 E Truman Ave, Fresno, CA 93725-0934 | 2020-08-24 |
| 1205458767 | Gene Park | Dentist | 1367 E Saint James Cir, Fresno, CA 93720-1417 | 2020-05-07 |
| 1104464684 | Kazi Shafiul Moula | Dentist | Western Dental/ Brident 150bfo, 3077 W Shaw Ave, Fresno, CA 93711 | 2019-12-16 |
| 1336793488 | Harry Gill | Dentist | 5492 N Palm Ave Ste A, Fresno, CA 93704-1960 | 2019-07-26 |
| 1619433711 | Beacon Dental Group | Dentist | 6099 N. First Ste Ste 102, Fresno, CA 93710 | 2019-02-13 |
| 1295209823 | Western Dental Services, Inc. | Dentist | 5776 N Blackstone Ave Ste 104, Fresno, CA 93710-5026 | 2019-01-16 |
| 1922570134 | Charles Keith Diddy | Dentist | 5637 N Palm Ave Apt B, Fresno, CA 93704-1829 | 2018-12-28 |
| 1659847549 | S Mavi,d.d.s., Incorporated | Dentist | 4007 N Marks Ave Ste 102, Fresno, CA 93722-4555 | 2018-10-17 |
| 1558875633 | Manbir Kaur Sandhu | Dentist | 605 S Shelly Ave, Fresno, CA 93727-6570 | 2017-11-28 |
| 1699285148 | Joann Alvine Levy | Dentist | 2179 E Olympic Ave, Fresno, CA 93730-5157 | 2017-10-10 |
| Find all providers in FRESNO | ||||
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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.