BOHANNAN DENTAL CORPORATION (NPI# 1558422725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558422725 |
| Entity Type | Organization |
| Organization Name | BOHANNAN DENTAL CORPORATION |
| Other Organization Name | WILLIAM B. BOHANNAN DDS, MD |
| Practice Address |
2025 Forest Ave Suite 6 San Jose CA 95128-4806 |
| Practice Telephone | 4082861553 |
| Practice Fax Number | 4082868511 |
| Mailing Telephone | 4082861553 |
| Mailing Fax Number | 4082868511 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WILLIAM B BOHANNAN (OWNER PRESIDENT) |
| Authorized Official Telephone | 4082861553 |
| Authorized Official Credential | D.D.S., M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
A66471 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| William B. Bohannan DDS, MD | Other Name - Individual/Organization |
| Street Address |
2025 FOREST AVE SUITE 6 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-4806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144291691 | Stephen N. Dombro | Dentist | 2025 Forest Ave, Suite 1, San Jose, CA 95128-4806 | 2006-01-31 |
| 1477782555 | Hernan Cardenas | Dentist | 2025 Forest Ave, Suite #3, San Jose, CA 95128-4806 | 2009-07-09 |
| 1659587228 | Janet Fishstrom Dombro | Specialist | 2025 Forest Ave, Suite 1, San Jose, CA 95128-4806 | 2007-05-14 |
| 1508964792 | Deborah A. Shiba | Dentist | 2025 Forest Ave, Suite #7, San Jose, CA 95128-4806 | 2006-09-20 |
| 1285676551 | Anthony Joseph Badame | Dermatology | 2025 Forest Ave, Suite 9, San Jose, CA 95128-4806 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356991038 | Aulakh Dental Corporation | Clinic/Center | 2195 Monterey Hwy Ste 30, San Jose, CA 95125-1069 | 2019-09-16 |
| 1023666989 | Douglas Maxson | Clinic/Center | 1198 S De Anza Blvd, San Jose, CA 95129-3632 | 2019-09-03 |
| 1366914574 | Beech & Reid Dental Partnership | Clinic/Center | 2945 The Villages Pkwy, San Jose, CA 95135-1451 | 2018-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931408 | Joseph A. Geleris | Clinic/Center | 132 N Vermont Ave, Glendora, CA 91741-5315 | 2020-10-27 |
| 1619524428 | Eliza Berris Dds, Inc. | Clinic/Center | 19851 Yorba Linda Blvd Ste 201-202, Yorba Linda, CA 92886-2864 | 2019-08-26 |
| 1497309306 | Acevedo Dental Corp | Clinic/Center | 1857 E 4th St, Ontario, CA 91764-2601 | 2019-07-29 |
| 1457911992 | Salina Mahgerefteh Dds Inc | Clinic/Center | 853 Warner Ave, Los Angeles, CA 90024-3327 | 2019-06-17 |
| 1588121248 | Trinh Thi Bui D.d.s.a Dental Corporation | Clinic/Center | 18510 Gridley Rd, Artesia, CA 90701 | 2019-02-28 |
| 1073082079 | Ucsf Dental Oncology | Clinic/Center | 513 Parnassus Avenue, Room S741, San Francisco, CA 94143-2205 | 2018-11-19 |
| 1033696406 | Daniel E Niemann Dds Dental Corporation | Clinic/Center | 2050 Huntington Dr Ste B, South Pasadena, CA 91030-4900 | 2018-07-27 |
| 1104318013 | Louis Gallia Md Medical Corp | Clinic/Center | 87 Scripps Dr #112, Sacramento, CA 95825 | 2018-06-06 |
| 1134624638 | Diem Cao Dds Inc | Clinic/Center | 8813 Alondra Blvd, Paramount, CA 90723-4603 | 2018-03-27 |
| 1013305689 | Mason Y. Lee, Dds, A Professional Corp | Clinic/Center | 750 Las Gallinas Ave Ste 207, San Rafael, CA 94903-3432 | 2015-01-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BOHANNAN DENTAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.