Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Charles Vansicklen, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629489315

Dr. Charles Vansicklen, DDS is a Student in an Organized Health Care Education/Training Program in Stockton, California. Registered with an NPI since 2014.

In the registry since
2014
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

8619 Emanuel Way
Stockton, CA 95212-1423
Phone: (209) 931-7931
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1629489315
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 15, 2014
Last updated in NPPESMay 15, 2014
Mailing address1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001

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