DR. GORDON LADD DOUGLASS (NPI# 1801010699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801010699 |
| Entity Type | Individual |
| Full Name | DR. GORDON LADD DOUGLASS |
| Credential | D.D.S. |
| Practice Address |
3960 El Camino Ave Suite 1 Sacramento CA 95821-6534 |
| Practice Telephone | 9164834964 |
| Practice Fax Number | 9164836380 |
| Mailing Telephone | 9164834964 |
| Mailing Fax Number | 9164836380 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
21792 | CA | Dental Providers |
| Street Address |
3960 EL CAMINO AVE SUITE 1 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-6534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083619795 | Robert N Katibah | Dentist | 3960 El Camino Ave, Ste 4, Sacramento, CA 95821-6534 | 2005-06-17 |
| 1972916369 | Upendra J Patel Dds Inc | Dentist | 3960 El Camino Ave, Suite 2, Sacramento, CA 95821-6534 | 2014-06-04 |
| 1801048566 | Jeffrey Jason Rosa | Dentist | 3960 El Camino Ave, 5, Sacramento, CA 95821-6534 | 2008-10-14 |
| 1235349010 | John Bishop Childers | Dentist | 3960 El Camino Ave, Ste #3, Sacramento, CA 95821-6534 | 2007-05-23 |
| 1205975059 | Wilmonte Lee Penner | Dentist | 3960 El Camino Ave, #6, Sacramento, CA 95821-6534 | 2007-02-06 |
| 1649337270 | Upendra Patel | Dentist | 3960 El Camino Ave, Suite 2, Sacramento, CA 95821-6534 | 2007-01-02 |
| 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 | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104276765 | Behdad Javdan | Dentist | 5009 Bremner Way, Apt #2, Sacramento, CA 95841-4622 | 2016-06-15 |
| 1386029270 | Sarmad Paydar | Dentist | 1017 L St # 684, Sacramento, CA 95814-3805 | 2015-07-21 |
| 1982096897 | Ronald R. Rott | Dentist | 4145 Garden Hwy, Sacramento, CA 95834-9600 | 2015-03-02 |
| 1760721104 | Ramandeep K Gill | Dentist | 3290 Arena Blvd Ste 610, Sacramento, CA 95834-3003 | 2013-02-05 |
| 1932487410 | Dorel Onea | Dentist | 717 13th St, Suite A, Sacramento, CA 95814-1951 | 2011-08-01 |
| 1326240854 | Ching-yin Tsai | Dentist | 4150 Truxel Rd, Suite D, Sacramento, CA 95834-3761 | 2007-06-05 |
| 1881721199 | Robin Howard Berrin | Dentist | 1810 Professional Dr, Sacramento, CA 95825 | 2007-02-27 |
| 1568597516 | Capital Periodontal Group | Dentist | 1810 Professional Drive, Sacramento, CA 95825 | 2007-02-22 |
| 1336292028 | Leland Lee | Dentist | 2131 Capitol Ave Ste 200, Sacramento, CA 95816-5755 | 2007-01-18 |
| 1417459397 | Matthew A. Korn, Dds, Professional Corporation | Dentist | 2830 G St Ste 100, Sacramento, CA 95816-3784 | 2018-03-06 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95821 |
Please comment or provide details below to improve the information on DR. GORDON LADD DOUGLASS.
| 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.