Dr Andrek Skred Ingersoll Dental Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DR ANDREK SKRED INGERSOLL DENTAL CORPORATION

Practice address

1473 Live Oak Blvd
Yuba City, CA 95991-2920

Phone

(530) 751-0599

NPI assigned

Mar 18, 2025

Organization subpart

No

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

Authorized official

Name

Leeann Blazer

Title

Director of Operations

Phone

(707) 673-7531

Specialties & licenses 1

Addresses

Other names 1

• Feather River Kids Dentistry Doing business as

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1720888654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21720 2ND ST",
            "city": "BURNEY",
            "state": "CA",
            "postal_code": "960139737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1473 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959912920",
            "telephone_number": "530-751-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ANDREK SKRED INGERSOLL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "BLAZER",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "707-673-7531"
    },
    "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": "Feather River Kids Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronda Recha' Dorsey, LPT
• Angeline Dorvil
• Ramandeep Dosanjh, MD
• Jennifer Dawn Dost
• Gail A Doty, P.T.
• Dr. Brar, Inc.
• Dr. Larry Ozeran
• Dr. Page Hudson Dental Corporation
• Connie Drago, RN
• DRS Salem and Soliman Dental Corp

• Pediatric Dentistry in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.