Organization Active NPI

Gus Charles Petras DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Redding, CA
National Provider Identifier
1790853653
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
22171 Issued in CA
Legal business name
GUS CHARLES PETRAS DDS
Practice address
400 Hartnell Avenue
Redding, CA 96002-1848
Phone
(530) 222-2473
Fax
(530) 222-3718
NPI assigned
Nov 30, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Gus Charles Petras, DDS
Title
Dentist
Phone
(530) 222-2473

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 22171 CA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 22171 CA Primary

Addresses

Primary practice location

400 Hartnell Avenue
Redding, CA 96002-1848

Mailing address

400 Hartnell Avenue
Redding, CA 96002-1848
Phone (530) 222-2473

Other identifiers 1

IdentifierTypeStateIssuer
B2217101OtherCAMEDICAL DENTICAL

National Provider Directory

National Provider Directory

Locations

400 Hartnell Ave
Redding, CA 96002
Phone (530) 222-2473

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1790853653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HARTNELL AVENUE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021848",
            "telephone_number": "530-222-2473",
            "fax_number": "530-222-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARTNELL AVENUE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021848",
            "telephone_number": "530-222-2473",
            "fax_number": "530-222-3718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUS CHARLES PETRAS DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PETRAS",
        "authorized_official_first_name": "GUS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "530-222-2473",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "22171",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "22171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DENTICAL",
            "identifier": "B2217101",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.