Mark W. Redford, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60371 Issued in CA

Practice address

79 Scripps Dr Ste 204
Sacramento, CA 95825-6208

Phone

(916) 565-2570

Fax

(916) 569-8467

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Redford Dental Group Inc

  dba Redford Smiles

  • Dental Clinic/Center
  • Sacramento, CA
  • NPI 1902654528
  NPD
• Scripps Dental Group

  • Dentist
  • Sacramento, CA
  • NPI 1811154313
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1679531826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SCRIPPS DR STE 204",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256208",
            "telephone_number": "916-565-2570",
            "fax_number": "916-569-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SCRIPPS DR STE 204",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256208",
            "telephone_number": "916-565-2570",
            "fax_number": "916-569-8467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6246 Fair Oaks Blvd",
            "address_purpose": "LOCATION",
            "city": "Carmichael",
            "state": "CA",
            "postal_code": "956084808",
            "country_code": "US",
            "telephone_number": "916-972-8851",
            "fax_number": "916-972-8912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDFORD",
        "first_name": "MARK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3846",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Redeemability
• Redefining You Therapy, Incorporated
• Victoria Catherine Reden
• Redfern Family Therapy and Consulting Inc.
• Redford Dental Group Inc (Redford Smiles)
• Alisha Jacobs Redhouse
• Tiara Redick, BA, RBT
• Olga Redko
• Ann R Redman, CNM, RN
• David Redman, ATC

• General Practice Dentistry in Sacramento, CA
• Providers in Sacramento, 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 May 8, 2024; 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.