Dr. Gudella San Juan Licaros , DDS
Dentist • Lancaster, PA
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. Gudella Licaros has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Gudella Licaros, DDS was a registered Dentist practicing in Lancaster, PA. Throughout an active medical career spanning 18 years, Dr. Licaros provided care at the practice location at 2135 NOLL DRIVE until profile deactivation on 2024-04-24.
Practice Location & Contact Primary Location
2135 Noll Drive
Suite C
Lancaster, PA 17603
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist in Lancaster, PA
Practicing in Lancaster, PA (3554 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 122300000X
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Counselor
Counselor
Master of Education
Social Worker
Licensed Social Worker
Dentist - General Practice
Doctor of Dental Surgery
Counselor - Professional
Case Manager/Care Coordinator
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on April 24, 2024
Dentist (License #043676 in NY)
NPI status registered as active in NPPES database
Registered at 2135 NOLL DRIVE, SUITE C, LANCASTER, PA 17603 (Tel: 7173977625)
Registered at 2135 NOLL DRIVE, SUITE C, LANCASTER, PA 17603 (Tel: 7173977625)
Recorded as GUDELLA LICAROS, DDS
Dentist (License #DS037692 in PA)
Dentist (License #043676 in NY)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
2135 Noll Drive, Suite C
Lancaster, PA 17603
Phone: 7173977625
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