Provider Demographics
NPI:1720821986
Name:STRAND, ELLI (DMD)
Entity type:Individual
Prefix:
First Name:ELLI
Middle Name:
Last Name:STRAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3376 KENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-9532
Mailing Address - Country:US
Mailing Address - Phone:701-739-4446
Mailing Address - Fax:
Practice Address - Street 1:1400 MARKET ST STE 8103
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1050
Practice Address - Country:US
Practice Address - Phone:530-246-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist