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SHASTA KIDS DENTISTRY
NPI 1528668746
Dentist - Pediatric Dentistry in Redding, CA

Active since October 27, 2020
2775 PARK MARINA DR STE A, REDDING, CA 96001(919) 656-3004 Get Directions Write a Review

NPPES record last updated: April 29, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Apr 29, 2021, Oct 27, 2020 (2 updates tracked since 2020).

About Shasta Kids Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHASTA KIDS DENTISTRY (NPI 1528668746) is a healthcare organization registered as a pediatric dentistry in Redding, California and active in the NPI registry since October 2020. The organization lists Andy Jeffrey Ingersoll, Manager, as its authorized official.

NPPES Registry Identity

NPI1528668746
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameANDREK J INGERSOLL DENTAL CORPORATION
Location Address2775 PARK MARINA DR STE ARedding, CA 96001-2840
Mailing Address3300 N Triumph Blvd Ste 100Lehi, UT 84043-5046 · (801) 494-4949
Phone(919) 656-3004
Organization SubpartNo
Authorized OfficialAndy Jeffrey IngersollManager · (530) 579-1722
Enumeration DateOctober 27, 2020
Last NPPES UpdateApril 29, 20212 updates tracked since enumeration
NPPES CertifiedApril 29, 2021
✔ NPI 1528668746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
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.
2775 PARK MARINA DR STE A, Redding, CA 96001
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Other Names 1

Doing Business AsShasta Kids Dentistry

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

QUAILHEARST CORP
Clinic/Center (Dental)
2775 PARK MARINA DR STE A
REDDING, CA 96001
Shasta County (530) 949-8221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrek J Ingersoll Dental Corporation's NPI number?

The NPI number for Andrek J Ingersoll Dental Corporation is 1528668746. It was assigned to this organization in the NPPES registry on October 27, 2020. The provider is doing business as Shasta Kids Dentistry.

Where is Andrek J Ingersoll Dental Corporation located?

Andrek J Ingersoll Dental Corporation is located at 2775 Park Marina Dr Ste A, Redding, CA 96001. The listed phone number is (919) 656-3004.

What is Andrek J Ingersoll Dental Corporation's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Andrek J Ingersoll Dental Corporation was last updated on April 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.