Provider Demographics
NPI:1447223672
Name:GERE, RICHARD RAYMOND (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RAYMOND
Last Name:GERE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 RAIMER WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5924
Mailing Address - Country:US
Mailing Address - Phone:916-489-1068
Mailing Address - Fax:
Practice Address - Street 1:9197 GREENBACK LN
Practice Address - Street 2:#B
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-4792
Practice Address - Country:US
Practice Address - Phone:916-988-1744
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD226031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics