Douglas and Kloss Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DOUGLAS AND KLOSS DENTAL

Doing business as

Heritage Oak Dental

Practice address

3700 Atherton Rd
Rocklin, CA 95765-3717

Phone

(916) 626-4050

NPI assigned

Mar 8, 2013

Organization subpart

No

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

Authorized official

Name

Shane Mark Douglas, DDSNPI 1902169774

Title

President

Phone

(916) 626-4050

Specialties & licenses 1

Addresses

Other names 1

• Heritage Oak Dental Doing business as

Locations

Practitioners 2

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

• Shane Mark Douglas, D.D.S.

  • Dentist
  • Rocklin, CA
  • NPI 1902169774
  NPD (past) Authorized official
• Benjamin Devere Kloss, D.M.D.

  • Dentist
  • Rocklin, CA
  • NPI 1962950204
  NPD (past)

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1447591987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 ATHERTON RD",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653717",
            "telephone_number": "916-626-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 ATHERTON RD",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653717",
            "telephone_number": "916-626-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS AND KLOSS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-626-4050",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Oak Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Oak Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rhonda Doran
• Debra Lynn Dorer, LMFT
• Nataliya Dorofeyev, PA-C
• Robert Dotson
• Liv Ruthanne Dougherty
• Shane Mark Douglas, D.D.S.
• Nicole Dow
• Arlene Lee Downing-Yaconelli, PHARMD
• Teri Lynn Doyle, PSYD
• Ayla Xandra Dozier

• Dentist in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.