JORDAN GADDIS D.D.S. A PROFESSIONAL DENTAL CORPORATION (NPI# 1790263887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790263887 |
| Entity Type | Organization |
| Organization Name | JORDAN GADDIS D.D.S. A PROFESSIONAL DENTAL CORPORATION |
| Practice Address |
2835 Eastern Ave Ste 3 Sacramento CA 95821-5400 |
| Practice Telephone | 9164868558 |
| Mailing Telephone | 9164868558 |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |
| Authorized Official Name | JORDAN GADDIS (DENTIST) |
| Authorized Official Telephone | 9162066902 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
101617 | CA | Ambulatory Health Care Facilities |
| Street Address |
2835 EASTERN AVE STE 3 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-5400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100717 | Denise Renee Landgraf | Licensed Vocational Nurse | 3615 Marconi Ave, Sacramento, CA 95821 | 2020-10-05 |
| 1770053258 | Oksana A Shutkova | Behavior Technician | 2823 El Camino Avenue, Appt #19, Sacramento, CA 95821 | 2018-11-28 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1386123438 | Rene William Villanueva | Marriage & Family Therapist | 3650 Auburn Blvd Bldg C-208, Sacramento, CA 95821 | 2018-08-09 |
| 1558853135 | Behavioral Health Solutions of The Pacific | Clinic/Center | 2829 Watt Avenue, Suite 200, Sacramento, CA 95821 | 2018-05-31 |
| 1679064091 | Carrissa Jean Angelique Bishop | Counselor | 3550 Watt Avenue, Suite 140, Sacramento, CA 95821 | 2018-05-21 |
| 1164943049 | Vanessa Selene Tinajero | Social Worker | 3615 Macorni Ave, Sacramento, CA 95821 | 2017-06-30 |
| 1316488562 | Lucas Hansen | Student in an Organized Health Care Education/Training Program | 3007 Clairidge Oak Ct, Sacramento, CA 95821 | 2017-03-20 |
| 1215383054 | Mark Brufladt | Physical Therapy Assistant | 3548 Ardmore Rd, Sacramento, CA 95821 | 2016-05-11 |
| 1053782789 | Marianna Jakucska | Marriage & Family Therapist | 2740 Fulton Ave Ste 100c, Sacramento, CA 95821 | 2015-10-07 |
| Find all providers in zip 95821 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434396 | Donald E. Clarke, Dds, Inc. | Clinic/Center | 930 Florin Rd Ste 104, Sacramento, CA 95831-5002 | 2020-10-12 |
| 1619599529 | Us Dental Care | Clinic/Center | 1901 Watt Ave Ste 4, Sacramento, CA 95825-2152 | 2020-05-13 |
| 1104484807 | Health and Life Organization, Inc. | Clinic/Center | 7275 E Southgate Dr Ste 106, Sacramento, CA 95823-2610 | 2019-05-29 |
| 1013488931 | Webber Dental Group, Inc | Clinic/Center | 905 Secret River Dr Ste A, Sacramento, CA 95831-3437 | 2018-12-17 |
| 1104336478 | Louis M Kim, A Professional Dental Corporation | Clinic/Center | 1824 Avondale Ave, Sacramento, CA 95825-1378 | 2017-10-02 |
| 1326403544 | Lawrence Lau, Dmd, PC | Clinic/Center | 8848 Calvine Rd, Suite 120, Sacramento, CA 95828-9334 | 2015-12-16 |
| 1023445335 | Arthur A. L. Burbridge Dds Inc. | Clinic/Center | 7485 Rush River Dr, Suite 755, Sacramento, CA 95831-5259 | 2013-10-01 |
| 1477993376 | Brenda Ho, Dds, Inc. | Clinic/Center | 905 Secret River Drive, Suite E, Sacramento, CA 95831 | 2013-06-25 |
| 1821357492 | Wellspace Health | Clinic/Center | 8231 E Stockton Blvd, Suite C, Sacramento, CA 95828-8202 | 2012-05-16 |
| 1346423316 | Melvin W. Walters, Dds - A Dental Corporation | Clinic/Center | 4450 Duckhorn Dr Ste B, Sacramento, CA 95834-2589 | 2007-12-12 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95821 |
Please comment or provide details below to improve the information on JORDAN GADDIS D.D.S. A PROFESSIONAL DENTAL CORPORATION.
| 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.