Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1457560187 Deactivated / Inactive NPI Male Practitioner

Dr. Jerome Michael Widlow , DDS

Dentist - General Practice • Redding, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jerome Widlow has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 21, 2007
NPI Deactivation Date October 13, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Jerome Widlow, DDS was a registered Dentist - General Practice practicing in Redding, CA. Throughout an active medical career spanning 16 years, Dr. Widlow provided care at the practice location at 3330 CHURN CREEK RD until profile deactivation on 2023-10-13.

Practice Location & Contact Primary Location

Practice Address

3330 Churn Creek Rd
Ste. D-3

Redding, CA 960022532

Telephone 5302241503
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Redding, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 2.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
63 Specialists

Practicing in Redding, 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA B20307

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

5 Associated Practitioners
Edward Fruzza

Pharmacist

NPI 1417095167
Blake Massey , PA

Physician Assistant - Medical

NPI 1720134810

Physician Assistant

Cherie Booker , FNP

Nurse Practitioner - Family

NPI 1740309301

Family Nurse Practitioner

Dr. Raymond Hayden , DDS

Dentist - General Practice

NPI 1811148695

Doctor of Dental Surgery

Dr. Richard Pepple , MD

Internal Medicine

NPI 1902974421

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated October 13, 2023

Record deactivated on October 13, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 3330 CHURN CREEK RD, STE. D-3, REDDING, CA 960022532 (Tel: 5302241503)

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Updated Business Mailing Address July 08, 2007

Registered at 3330 CHURN CREEK RD, STE. D-3, REDDING, CA 960022532 (Tel: 5302241503)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JEROME WIDLOW, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #B20307 in CA)

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Initial NPI Registration & Enumeration May 21, 2007

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: 1457560187
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 21, 2007
Last Update: July 08, 2007
Deactivation Date: October 13, 2023

Mailing Address

3330 Churn Creek Rd, Ste. D-3

Redding, CA 960022532

Phone: 5302241503

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.