DR. JERRY H. WATANABE (NPI# 1558486514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558486514 |
| Entity Type | Individual |
| Full Name | DR. JERRY H. WATANABE |
| Credential | D.D.S., M.S. |
| Practice Address |
9301 Fircrest Ln Ste 1 San Ramon CA 94583-3960 |
| Practice Telephone | 9258286972 |
| Mailing Telephone | 9258286972 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
18039 | CA | Dental Providers |
| Street Address |
9301 FIRCREST LN STE 1 |
| City | SAN RAMON |
| State | CA |
| Zip Code | 94583-3960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295375475 | Angel Beatrice Mckneely | Behavior Technician | 3150 Crow Canyon Place, Suite 110, San Ramon, CA 94583 | 2020-01-15 |
| 1205302247 | Asma Parisa Rezaye | Behavior Technician | 4708 Norris Canyon Rd, Unit 201, San Ramon, CA 94583 | 2018-10-17 |
| 1679055461 | Mary Martineau | Speech-Language Pathologist | 210 Porter Dr Ste 120, San Ramon, CA 94583 | 2018-08-29 |
| 1336631332 | Alison Jean Barnes | Behavior Technician | Goals for Autism, 1 Crow Canyon Court, San Ramon, CA 94583 | 2018-06-05 |
| 1730671975 | Michael Federico | Pharmacist | 2735 Ascot Drive, San Ramon, CA 94583 | 2018-06-04 |
| 1508384843 | Donor Network West | Organ Procurement Organization | 12667 Alcosta Blvd., Suite 500, San Ramon, CA 94583 | 2017-09-07 |
| 1265950141 | Danielle Lustig Fitch | Marriage & Family Therapist | 3180 Crown Canyon Pl. Ste 140, San Ramon, CA 94583 | 2017-08-31 |
| 1386166205 | Park Place Ambulatory Surgery Center | Orthopaedic Surgery | 100 Park Place, Suite 100, San Ramon, CA 94583 | 2017-07-12 |
| 1952822991 | Virginia Rutledge Mosby | Marriage & Family Therapist | 3180 Crow Canyon Place #140, San Ramon, CA 94583 | 2017-06-29 |
| 1437684784 | Nakhla Dental Group | Dentist | Crow Canyon Dental, 2821 Crow Canyon Road #200, San Ramon, CA 94583 | 2017-04-25 |
| Find all providers in zip 94583 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023202298 | Gary William Greer | Dentist | 2817 Crow Canyon Rd Ste 200, San Ramon, CA 94583-1639 | 2007-08-30 |
| 1609075910 | H. Derick Phan | Dentist | 11040 Bollinger Canyon Rd, Suite K, San Ramon, CA 94582-4959 | 2007-07-16 |
| 1922185461 | Barbara G. Yee, Dds, Ms, Inc | Dentist | 3130 Crow Canyon Rd Ste B, San Ramon, CA 94583-1365 | 2006-11-01 |
| 1962580936 | Dr. Sandy Bigman | Dentist | 525 Bollinger Canyon Way Ste 102, San Ramon, CA 94582-4935 | 2006-11-01 |
| 1821404179 | Arash Abolfazlian, Dds, Msd, Inc. | Dentist | 111 Deerwood Rd, Suite 390, San Ramon, CA 94583-4409 | 2014-07-08 |
| 1780011106 | Arash Abolfazlian | Dentist | 111 Deerwood Rd, San Ramon, CA 94583-4409 | 2013-09-30 |
| 1275856817 | Jenny Yoo | Dentist | 11040 Bollinger Canyon Rd, Suite I, San Ramon, CA 94582-4969 | 2010-03-10 |
| 1215160106 | Tiffany Louie Hong | Dentist | 11040 Bollinger Canyon Rd, Suite I, San Ramon, CA 94582-4969 | 2009-08-26 |
| 1225225071 | Margarita Monica Lachica | Dentist | 9301 Fircrest Ln, Suite 5, San Ramon, CA 94583-3960 | 2007-09-25 |
| 1174727648 | Harry Robert Van Den Berg | Dentist | 1501 Bollinger Canyon Rd, Suite A, San Ramon, CA 94583-1758 | 2007-06-11 |
| Find all providers in SAN RAMON | ||||
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| 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.