Garret S. Madderra, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39837 Issued in CA

Practice address

2020 Hurley Way
Suite #290
Sacramento, CA 95825-3223

Phone

(916) 929-0969

Fax

(916) 929-2243

NPI assigned

May 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Garret Madderra DDS, LP

  • Dentist
  • Sacramento, CA
  • NPI 1487862280
  NPD (past)
• Le Vu Dental Corporation

  dba Arden Arcade Family Dentistry

  • Dentist
  • Sacramento, CA
  • NPI 1669853479
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033327325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 HURLEY WAY",
            "address_2": "SUITE #290",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253223",
            "telephone_number": "916-929-0969",
            "fax_number": "916-929-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 HURLEY WAY",
            "address_2": "SUITE #290",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958253223",
            "telephone_number": "916-929-0969",
            "fax_number": "916-929-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDERRA",
        "first_name": "GARRET",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moriah Danielle Maddalena, MD
• Christopher Madden
• Lori Kennedy Madden, PHD, RN, ACNP
• Ross Patrick Madden, PA-C
• Sadey Ashley Madden
• Richard J Maddock, M.D.
• Marlo Maddox-Kleckley, M.D.
• Justin Maddux, DC
• Kathleen Helen Madeira, RN
• Madeleine Shernock Corp.

• General Practice Dentistry in Sacramento, CA
• Providers in Sacramento, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.