C. Randy Landis, DDS, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

31940 Issued in CA

Legal business name

C. RANDY LANDIS, DDS, INC.

Practice address

80 Declaration Dr
Suite 101
Chico, CA 95973-4913

Phone

(530) 893-3912

Fax

(530) 893-2451

NPI assigned

May 28, 2009

Organization subpart

No

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

Authorized official

Name

Charles Randy Landis, DDS,OMSNPI 1063584399

Title

President/Owner

Phone

(530) 893-3912

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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

  • Oral and Maxillofacial Surgery (Dentist)
  • Oroville, CA
  • NPI 1063584399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1306071758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 DECLARATION DR",
            "address_2": "SUITE 101",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734913",
            "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": "80 DECLARATION DR",
            "address_2": "SUITE 101",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734913",
            "telephone_number": "530-893-3912",
            "fax_number": "530-893-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. RANDY LANDIS, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "LANDIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "530-893-3912",
        "authorized_official_credential": "DDS,OMS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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": []
}

• Chrystal Lynn Buttler
• Shane Thomas Buttler
• Brett Lynn Butz, MD
• Skylar Cunniff Byelogurov, OD
• Shelly Marlene Byrd, MENTAL HEALTH WORKER
• C.Srinivas Rao,D.D.S., Inc.
• C&O Pediatric Daycare
• Lee Caba
• Isela Cabello Romero
• Frida Cabrera

• Oral and Maxillofacial Surgery (Dentist) in Chico, CA
• Providers in Chico, 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 Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.