WALNUT CREEK-DANVILLE ORAL SURGERY (NPI# 1679878763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679878763 |
| Entity Type | Organization |
| Organization Name | WALNUT CREEK-DANVILLE ORAL SURGERY |
| Practice Address |
1855 San Miguel Dr Suite 25 Walnut Creek CA 94596-5279 |
| Practice Telephone | 9259345565 |
| Practice Fax Number | 9259346003 |
| Mailing Telephone | 9259345565 |
| Mailing Fax Number | 9259346003 |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2018-01-29 |
| Authorized Official Name | TERRI MATULOVICH (OFFICE MANAGER) |
| Authorized Official Telephone | 9259345565 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
37490 | CA | Ambulatory Health Care Facilities |
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
30346 | CA | Ambulatory Health Care Facilities |
| Street Address |
1855 SAN MIGUEL DR SUITE 25 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5279 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013990613 | Joseph F Barakeh | Ophthalmology | 1855 San Miguel Dr, #28, Walnut Creek, CA 94596-5214 | 2005-11-29 |
| 1497131262 | Martin Lee Schellinck Dds | Dentist | 1855 San Miguel Dr, Suite 14, Walnut Creek, CA 94596-5279 | 2015-08-04 |
| 1740694181 | Wafelbakker Anderson Orthodontics | Dentist | 1855 San Miguel Dr, Ste 33, Walnut Creek, CA 94596-5279 | 2014-06-13 |
| 1982015517 | Alex Rader | Dentist | 1855 San Miguel Dr, Suite 12, Walnut Creek, CA 94596-5279 | 2014-05-16 |
| 1114285871 | Michelle Masuda | Dentist | 1855 San Miguel Dr, #22, Walnut Creek, CA 94596-5279 | 2012-05-01 |
| 1184903569 | Martin Lee Schellinck | Dentist | 1855 San Miguel Dr, Suite 14, Walnut Creek, CA 94596-5279 | 2011-08-16 |
| 1063741601 | Alexis Smith-baumann | Psychologist | 1855 San Miguel Dr, Ste 23, Walnut Creek, CA 94596-5290 | 2009-12-10 |
| 1154576346 | Mark R. Maher Dds, Inc. | Clinic/Center | 1855 San Miguel Dr, Suite 1, Walnut Creek, CA 94596-5279 | 2008-12-01 |
| 1831372671 | Keith Turreff White | Dentist | 1855 San Miguel Dr, Suite 20, Walnut Creek, CA 94596-5279 | 2007-12-16 |
| 1417140971 | Jennifer Lynn Larocque | Dentist | 1855 San Miguel Dr, Suite 9, Walnut Creek, CA 94596-5279 | 2007-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| 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 |
|---|---|---|---|---|
| 1942232541 | Nestor Karas Dds Md Inc | Clinic/Center | 1800 San Miguel Dr, Walnut Creek, CA 94596-8606 | 2006-07-06 |
| 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 | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
Please comment or provide details below to improve the information on WALNUT CREEK-DANVILLE ORAL SURGERY.
| 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.