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C. RANDY LANDIS DDS INC. NPI 1306071758


NPI Information

NPI: 1306071758
Provider Name: C. RANDY LANDIS, DDS, INC.
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
80 DECLARATION DR
SUITE 101
CHICO, CA
ZIP 95973
Phone: (530) 893-3912
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C. RANDY LANDIS, DDS, INC. is an oral and maxillofacial surgery dentist in Chico, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. C. RANDY LANDIS, DDS, INC. NPI is 1306071758. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

80 DECLARATION DR
SUITE 101
CHICO, CA
ZIP 95973-913
Phone: (530) 893-3912
Fax: (530) 893-2451

The provider's authorized official is Charles Randy Landis .
The authorized official title is President/owner and has the following contact phone number (530) 893-3912.

The enumeration date for this NPI number is 5/28/2009 and was last updated on 11/3/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery31940CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DS0319400MEDICARE PINCALIFORNIA
2B31940MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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