Gaurav Addagatla, DDS
Individual provider Active NPI General Practice Dentistry · Carson, CA
NPI 1861314775 · NPPES record last updated Jul 30, 2026
Key facts
- NPI
- 1861314775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DDS113414 (CA)
- Practice address
- 612 E Carson St Ste 101
Carson, CA 90745-2896 - Phone
- (310) 469-9355
- NPI assigned
- Jul 30, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walter Jefferson, D.D.S., Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS113414 | CA | Yes |
Addresses
Primary practice location
612 E Carson St Ste 101
Carson, CA 90745-2896
Mailing address
647 Channel Way
Costa Mesa, CA 92627-3690
Phone (916) 749-8152
Other providers in Carson, CA
- Absolute Care Health Providers Inc
- Roman Emmanuel Acebedo
- Beheshteh Adabzadeh
- Ebony Adagun
- Joseph Adams
- Ade Osibamiro MD Inc
- Amanda Aden
- Cydanni Adenikinju
- Elsie Adoc
- Joel A Agacid Jr.
All providers in Carson, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.