Amanda Stephanie Ankrom, DDS
Individual provider Active NPI General Practice Dentistry · Sonora, CA
NPI 1467072256 · NPPES record last updated Feb 17, 2022
Key facts
- NPI
- 1467072256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 106620 (CA)
- Practice address
- 820 Delnero Dr Ste a
Sonora, CA 95370-6208 - Phone
- (209) 559-3113
- NPI assigned
- Apr 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106620 | CA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 106620 | CA | Yes |
Addresses
Primary practice location
820 Delnero Dr Ste a
Sonora, CA 95370-6208
Mailing address
820 Delnero Dr Ste a
Sonora, CA 95370-6208
Phone (209) 559-3113
Other providers in Sonora, CA
- Rebecca Ames-Block
- Sierra Brooke Amick
- Amanda Valerie Anderson
- Lisa Jewell Andrews
- Patricia Ann Andrews
- Douglas Ankrom
- Nicole Archer
- Gerard Emile Ardron
- Area 12 Agency on Aging
- Ocean Arellano
All providers in Sonora, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.