DR. RICHARD STEPHEN JENDERSECK (NPI# 1881812766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881812766 |
| Entity Type | Individual |
| Full Name | DR. RICHARD STEPHEN JENDERSECK |
| Credential | D.D.S, |
| Practice Address |
1416 Townview Ln Santa Rosa CA 95405 |
| Mailing Address |
1416 Townview Ln Santa Rosa CA 95405-7538 |
| Practice Telephone | 7075783010 |
| Practice Fax Number | 7075780343 |
| Mailing Telephone | 7075783010 |
| Mailing Fax Number | 7075780343 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
30223 | CA | Dental Providers |
| Street Address |
1416 TOWNVIEW LN |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801958558 | Jay Uemura | Dentist | 1416 Townview Ln, Santa Rosa, CA 95405-7538 | 2006-12-15 |
| 1154946622 | J. Jay Uemura, D.d.s. A Dental Corporation | Dentist | 1416 Townview Ln, Santa Rosa, CA 95405-7538 | 2020-06-10 |
| 1689892572 | Walter Reed Dickinson | Dentist | 1416 Townview Ln, Santa Rosa, CA 95405 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013047497 | Paul James Steigerwald | Dentist | 868 2nd St, Santa Rosa, CA 95404-4610 | 2007-03-06 |
| 1801958558 | Jay Uemura | Dentist | 1416 Townview Ln, Santa Rosa, CA 95405-7538 | 2006-12-15 |
| 1487730875 | James Alan Simonds | Dentist | 2213 Mendocino Ave, Suite A, Santa Rosa, CA 95403-3112 | 2006-10-27 |
| 1154946622 | J. Jay Uemura, D.d.s. A Dental Corporation | Dentist | 1416 Townview Ln, Santa Rosa, CA 95405-7538 | 2020-06-10 |
| 1306048608 | Gregory G Steiner | Dentist | 90 Doctors Park Dr # A, Santa Rosa, CA 95405-6615 | 2007-05-31 |
| 1295941474 | Patricia A Murray | Dentist | 1100 Sonoma Ave, Suite D, Santa Rosa, CA 95405-8901 | 2007-05-15 |
| 1689892572 | Walter Reed Dickinson | Dentist | 1416 Townview Ln, Santa Rosa, CA 95405 | 2007-04-23 |
| 1487703328 | Craig Wilson | Dentist | 4655 Hoen Ave, Suite 3, Santa Rosa, CA 95405-7800 | 2007-01-09 |
| 1720174592 | Christine Ford | Dentist | 101 Brookwood Ave, Suite 203, Santa Rosa, CA 95404-5259 | 2006-10-05 |
| 1518996099 | Gary Grill | Dentist | 1421 Guerneville Rd, Suite 102, Santa Rosa, CA 95403-7220 | 2006-06-30 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.