Andrekgbortho Ingersoll Dental Corporation
Andrekgbortho Ingersoll Dental Corporation is an Orthodontics and Dentofacial Orthopedics Dentistry in Granite Bay, California. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
4150 Douglas Blvd Ste BGranite Bay, CA 95746-5908
Phone: (916) 774-6986
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Orthodontics and Dentofacial Orthopedics Dentistry (primary) | Taxonomy 1223X0400X |
|---|
Record details
| NPI number | 1356216907 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Leeann Blazer — Director Of Operations · (707) 673-7531 |
| NPI enumerated | October 6, 2025 |
| Last updated in NPPES | October 6, 2025 |
| Certification date | October 6, 2025 |
| Mailing address | 3300 N Triumph Blvd Ste 100, Lehi, UT 84043-5046 |
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Dr. Austin Bauldry, DDS, MSD
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Iroshini Perera DDS Inc Dba Elevate Orthodontics
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Blain Jacobson, DMD
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