Charles Randolph Landis, D.D.S., O.M.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

31940 Issued in CA

Practice address

2990 Oro Dam Blvd E
Ste C
Oroville, CA 95966-5190

Phone

(530) 533-7900

Fax

(530) 533-3457

NPI assigned

Nov 14, 2006

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

Other identifiers 1

Other names 1

• Dr. C. Randy Landis Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Oral Surgery

Education

Loma Linda University School of Dentistry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• C. Randy Landis, DDS, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Chico, CA
  • NPI 1306071758
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1063584399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 FOREST AVE",
            "address_2": "STE 120",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959284390",
            "telephone_number": "530-893-3912",
            "fax_number": "530-893-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 ORO DAM BLVD E",
            "address_2": "STE C",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959665190",
            "telephone_number": "530-533-7900",
            "fax_number": "530-533-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "CHARLES",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S., O.M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "31940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B31940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C.",
            "last_name": "LANDIS",
            "middle_name": "RANDY",
            "prefix": "DR.",
            "credential": "D.D.S., O.M.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laila E. Chandy, M.D., Prof. Copr
• Frederick Laine, PHARMD
• Lake Oroville Country Retirement
• Lakeview Horizon Psychiatric Nursing Services Professional Corporation
• Kimran Kaur Lally
• Michael A Lang-Perry Jr.
• Garrett Lansdown
• Nancy M. Lao
• Roxanne Lara
• Coreen Lavonne Larsen-Griffen

• Oral and Maxillofacial Surgery (Dentist) in Oroville, CA
• Providers in Oroville, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.