THEODORE ROBERT SMALL


Address: 1301 Bonita Ave Apt 4, Berkeley, CA 94709-1983
Phone: 5105599097

THEODORE ROBERT SMALL (NPI# 1497112338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497112338
Entity Type Individual
Full Name THEODORE ROBERT SMALL
Credential DDS
Practice Address 1301 Bonita Ave Apt 4
Berkeley
CA 94709-1983
Practice Telephone 5105599097
Mailing Telephone 5105599097
Enumeration Date 2016-01-22
Last Update Date 2016-01-22
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122300000X Dentist 140487-9922 UT Dental Providers

Other Providers THEODORE SMALL

NPI Name Taxonomy Address Enumeration
1992704555 Theodore Robert Small Specialist 1840 Mease Dr, Suite 301, Safety Harbor, FL 34695-6605 2005-07-18

Office Location

Street Address 1301 BONITA AVE APT 4
City BERKELEY
State CA
Zip Code 94709-1983

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144868647 Komalpreet Kaur Pharmacist 1444 Shattuck Place, Berkeley, CA 94709 2019-12-16
1689189763 Lynn Rubin Marriage & Family Therapist 1524 Henry St., Berkeley, CA 94709 2017-12-11
1750825154 Stacy Taniguchi Psychologist 2000 Hearst Ave Ste 207, Berkeley, CA 94709 2016-12-05
1558804708 Tylynn Ludwig Dietitian, Registered 1525 Shattuck Ave Ste G, Berkeley, CA 94709 2016-11-21
1528316171 Leeat Zwick-louvton Physical Therapist 2209 Glen Ave, Berkeley, CA 94709 2012-08-29
1497016588 City of Berkeley Case Management 1901 Hearst Street, Berkeley, CA 94709 2012-06-05
1841591914 Dana Carr Psychologist 1078 Shattuck Avenue, #6, Berkeley, CA 94709 2010-11-05
1568639565 Harry Joseph Lieberman Marriage & Family Therapist 1933 Rose St, Berkeley, CA 94709 2008-05-09
1780806935 Martha W Knobler Marriage & Family Therapist 2045 Francisco Street, Berkeley, CA 94709 2007-05-03
1578690830 Alice H Brown Counselor 1607 Walnut Street # One, Berkeley, CA 94709 2007-02-27
Find all providers in zip 94709

Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

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.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568027183 Leila Pakravan Dentist 2136 University Ave, Berkeley, CA 94704-1026 2019-05-08
1467921288 Ethan Do Dentist 3017 Telegraph Ave Ste 310, Berkeley, CA 94705-2049 2018-11-21
1962817882 Ian Iwane Dds Dentist 1536 Blake St, None, Berkeley, CA 94703-1806 2014-06-30
1932549235 Erwin Yeh Dentist 1502 Walnut St Ste D, Berkeley, CA 94709-1563 2013-07-01
1144663766 Alicia Applin Dentist 2812 Piedmont Ave, Berkeley, CA 94705-2314 2013-04-12
1588969919 Martin L Goldman Dentist 900 Colusa Ave Ste 205-a, Berkeley, CA 94707-2319 2011-01-15
1316256712 Anthony Murray Dailley Dentist 2999 Regent St Ste 302, Berkeley, CA 94705-2118 2010-10-02
1912239567 Lindsey Koida Dentist 909 University Ave., Berkeley, CA 94710 2010-02-08
1568690824 Brian Marc Assael Dentist 2459a Ashby Ave, Berkeley, CA 94705 2009-06-25
1821236787 Stephen Kane Dentist 856 Contra Costa Ave, Berkeley, CA 94707-1920 2009-01-30
Find all providers in BERKELEY

Competitor

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City BERKELEY
Zip Code 94709

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Dataset Information

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.

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