Provider Demographics
NPI:1376762898
Name:BROWNRIDGE, GEORGE WASHINGTON II (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WASHINGTON
Last Name:BROWNRIDGE
Suffix:II
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 CEANOTHUS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7611
Mailing Address - Country:US
Mailing Address - Phone:530-343-1685
Mailing Address - Fax:530-343-6365
Practice Address - Street 1:2525 CEANOTHUS AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7611
Practice Address - Country:US
Practice Address - Phone:530-343-1685
Practice Address - Fax:530-343-6365
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA244361223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicare PIN