Provider Demographics
NPI:1811276413
Name:GAPPER, RICHARD LAYNE (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LAYNE
Last Name:GAPPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1902
Mailing Address - Country:US
Mailing Address - Phone:661-322-8815
Mailing Address - Fax:661-322-1054
Practice Address - Street 1:1735 28TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1902
Practice Address - Country:US
Practice Address - Phone:661-322-8815
Practice Address - Fax:661-322-1054
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27617122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist