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Active NPI 1861314775 Individual Practitioner Male Practitioner

Dr. Gaurav Addagatla , DDS

Dentist - General Practice • Carson, CA

Professional Overview & Biography Verified Profile Summary

Dr. Gaurav Addagatla, DDS is a registered healthcare professional specializing in Dentist - General Practice in Carson, CA. Practice services are available at 612 E CARSON ST STE 101 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

612 E Carson St Ste 101

Carson, CA 907452896

Telephone 3104699355
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Carson, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
28 Specialists

Practicing in Carson, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-30
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA DDS113414

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. Tiffany Pham , DMD

Dentist - General Practice

NPI 1336827302

Doctor of Dental Medicine

NPI 1548011174
NPI 1679912422

Doctor of Dental Surgery

NPI 1689492571

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 30, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location July 30, 2026

Registered at 612 E CARSON ST STE 101, CARSON, CA 907452896 (Tel: 3104699355)

📍
Updated Business Mailing Address July 30, 2026

Registered at 647 CHANNEL WAY, COSTA MESA, CA 926273690 (Tel: 9167498152)

👤
Provider Name / Credentials Updated July 30, 2026

Recorded as GAURAV ADDAGATLA, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2026

Dentist (License #DDS113414 in CA)

🟢
Initial NPI Registration & Enumeration July 30, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861314775
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 30, 2026
Last Update: July 30, 2026
Sole Proprietor: No

Mailing Address

647 Channel Way

Costa Mesa, CA 926273690

Phone: 9167498152

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.