Gabriel Enriquez, D.D.S., M.S.
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Fortuna, CA
NPI 1528169745 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1528169745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 52722 (CA)
- Practice address
- 1001 Loni Dr
Fortuna, CA 95540-2347 - Phone
- (707) 725-4409
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52722 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 52722 | CA | Yes |
Addresses
Primary practice location
1001 Loni Dr
Fortuna, CA 95540-2347
Mailing address
1001 Loni Dr
Fortuna, CA 95540-2347
Phone (707) 725-4409
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- Kelly Ehrhardt
- Kerisa Sue Elloway
- Courtney Embry
- Dana Louise Estevo
- Katherine Anne Talbert Estlin
- Family Foot Care Specialist Podiatry Center
- Family Foot Care Specialists Podiatry Center Inc
- Neal E Feuerman
All providers in Fortuna, CA · Orthodontics and Dentofacial Orthopedics 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 Jul 8, 2007. 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.