Dr Andrek Apd Ingersoll Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR ANDREK APD INGERSOLL DENTAL CORPORATION

Doing business as

Shasta Kids Dentistry

Practice address

2127 Airpark Dr
Redding, CA 96001-2433

Phone

(530) 356-4685

NPI assigned

Oct 10, 2024

Last updated

Oct 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrek Jeffrey Ingersoll, DMD

Title

Owner

Phone

(530) 579-1722

Specialties & licenses 1

Addresses

Other names 1

• Shasta Kids Dentistry Doing business as

Locations

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1790504298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 AIRPARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012433",
            "telephone_number": "530-579-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 AIRPARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012433",
            "telephone_number": "530-356-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ANDREK APD INGERSOLL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "INGERSOLL",
        "authorized_official_first_name": "ANDREK",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-579-1722",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shasta Kids Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eduard Doumanian, DDS
• Patricia Elise Dowless
• Kevin Downey
• Karen Doyle, NP
• Mark Thomas Doyle, D.D.S.
• Dr. Barber & Associates of Optometry, Inc.
• Dr. F. Shadan Inc.
• Dr. Farnaz Chegini, DMD, Inc. (Chegini Family Dentistry)
• Dr. Lila P. Wilson DDS, Inc.
• Patricia Ellen Drake, RN, BSN, PHN, MS

• Dental Clinic/Center in Redding, CA
• Providers in Redding, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.