GUS CHARLES PETRAS DDS NPI 1790853653

NPI Information

NPI: 1790853653
Provider Name: GUS CHARLES PETRAS DDS
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
400 HARTNELL AVENUE
REDDING, CA
ZIP 96002
Phone: (530) 222-2473
Get Directions

GUS CHARLES PETRAS DDS is a pediatric dentistry dentist in Redding, CA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. GUS CHARLES PETRAS DDS NPI is 1790853653. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

400 HARTNELL AVENUE
REDDING, CA
ZIP 96002-848
Phone: (530) 222-2473
Fax: (530) 222-3718

The provider's authorized official is Gus Charles Petras .
The authorized official title is Dentist and has the following contact phone number (530) 222-2473.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 8/22/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	22171	CALIFORNIA	Yes
2	1223X0400X	Dentist	Orthodontics and Dentofacial Orthopedics	22171	CALIFORNIA	X

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	B2217101	OTHER	CALIFORNIA	MEDICAL DENTICAL

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

NPI Synchronization or Removal

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