DR. BONNIE L PADWA (NPI# 1558351866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558351866 |
| Entity Type | Individual |
| Full Name | DR. BONNIE L PADWA |
| Credential | DMD, MD |
| Practice Address |
300 Longwood Ave Hu-158 Boston MA 02115-5724 |
| Practice Telephone | 6173556259 |
| Practice Fax Number | 6177381657 |
| Mailing Telephone | 6173556259 |
| Mailing Fax Number | 6177381657 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2008-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
17008 | MA | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 75473 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 3101207 | 05 | |
| MA | BCBS MA | J13074 | 01 |
| MA | TUFTS HEALTH PLAN | 730778 | 01 |
| Street Address |
300 LONGWOOD AVE HU-158 |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667539 | Barry Grant Zallen | Pediatrics | 300 Longwood Ave, Children's Hospital, Au 105, Boston, MA 02115-5724 | 2005-05-23 |
| 1730780669 | Hannah Fraser | Registered Nurse | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-06 |
| 1164023776 | Hannah Brewer | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-02 |
| 1104423680 | Justin Matthias Hintze | Otolaryngology | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-10-07 |
| 1295340388 | Kathryn Theresa Moffa | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1144835224 | Abby Elizabeth Bandi | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1558976845 | Hilary Segar Garber | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-13 |
| 1063026003 | Lauren M Dilullo | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-08 |
| 1013521004 | Carl Britto | Student in an Organized Health Care Education/Training Program | 300 Longwood Ave, Boston, MA 02115-5737 | 2020-09-07 |
| 1760096887 | Rebecca Marie Leslie | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518452705 | Yisi D Ji | Oral & Maxillofacial Surgery | 165 Cambridge St Ste 401, Mgh Dental Group, Boston, MA 02114-2750 | 2018-06-29 |
| 1457587065 | Zachary Scott Peacock | Oral & Maxillofacial Surgery | 55 Fruit Street, Warren 1201, Boston, MA 02114-2621 | 2009-06-10 |
| 1851580708 | Basim Jamal | Oral & Maxillofacial Surgery | 820 Harrison Ave, Fgh Building 4th Floor, Boston, MA 02118-2905 | 2007-10-16 |
| 1265447965 | Edward T Lahey IIi | Oral & Maxillofacial Surgery | 15 Parkman St Wac 230, Oral & Maxillofacial Surgery, Boston, MA 02114 | 2006-07-30 |
| 1720062284 | Lisa Campanella | Oral & Maxillofacial Surgery | 55 Fruit Street Cpz 401, Massachusetts General Hospital, Boston, MA 02114 | 2005-11-30 |
| 1689299927 | Grace Hsu | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-12 |
| 1063037778 | Nancy Zhu | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-09 |
| 1821612086 | Taylor M Vanhouten | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-03 |
| 1740804277 | Tapan P Dalal | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-01 |
| 1659995181 | Kate E Mcpherson | Oral & Maxillofacial Surgery | 55 Fruit St, Massachusetts General Hospital, Boston, MA 02114-2621 | 2020-06-01 |
| Find all providers in BOSTON | ||||
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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.