Healthcare Provider Details

I. General information

NPI: 1851878250
Provider Name (Legal Business Name): DR. JEFFREY A. SALADIN, DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RALEY BLVD SUITE 204
CHICO CA
95928
US

IV. Provider business mailing address

1164 NATIONAL DRIVE SUITE #40
SACRAMENTO CA
95834
US

V. Phone/Fax

Practice location:
  • Phone: 530-883-8589
  • Fax: 844-534-8464
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY A SALADIN
Title or Position: OWNER
Credential: DDS
Phone: 916-333-0563