Dr Andrek Rosped Ingersoll Dental Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DR ANDREK ROSPED INGERSOLL DENTAL CORPORATION

Practice address

1431 Secret Ravine Pkwy Ste 151
Roseville, CA 95661-4051

Phone

(916) 782-3161

NPI assigned

Feb 4, 2026

Organization subpart

No

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

Authorized official

Name

Stacy Kingrey, KINGREY

Title

Regional Manager

Phone

(530) 356-4685

Specialties & licenses 1

Addresses

Other names 1

• Bear Hollow Kids Dentistry - Roseville Doing business as

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1689525958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 SECRET RAVINE PKWY STE 151",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614051",
            "telephone_number": "916-782-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 SECRET RAVINE PKWY STE 151",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614051",
            "telephone_number": "916-782-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ANDREK ROSPED INGERSOLL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "KINGREY",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "530-356-4685",
        "authorized_official_credential": "KINGREY"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bear Hollow Kids Dentistry - Roseville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.