Fred D. Coffman, D.D.S., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

029142 Issued in CA

Legal business name

FRED D. COFFMAN, D.D.S., INC.

Practice address

1801 Douglas Blvd
Suite B
Roseville, CA 95661-2913

Phone

(916) 784-3337

Fax

(916) 784-7459

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Fred D Coffman, DDS

Title

President

Phone

(916) 784-3337

Specialties & licenses 1

Addresses

Tax ID family

Fred D Coffman DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fred D Coffman DDS Inc

  • Dental Clinic/Center
  • Roseville, CA
  • NPI 1871769901
  NPD tax ID

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396825766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 DOUGLAS BLVD",
            "address_2": "SUITE B",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612913",
            "telephone_number": "916-784-3337",
            "fax_number": "916-784-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 DOUGLAS BLVD",
            "address_2": "SUITE B",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612913",
            "telephone_number": "916-784-3337",
            "fax_number": "916-784-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED D. COFFMAN, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-784-3337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "029142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy L Franks, CADC-I
• Vanessa G Franz
• Jamie Frazier, LMFT
• Rachael D Frazier, AGPCNP
• Fred D Coffman DDS Inc
• Fred P. Guarcello & Peter S. Klem PTR
• Fred P. Guarcello, O.D.
• Fred Weiland MD, Inc
• Frederick R Sautter Licensed Clinical Social Worker Inc
• Laura M Frederick, LMFT

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.