WILLIAM B. BOHANNAN DDS, MD, PC (NPI# 1669533832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669533832 |
| Entity Type | Organization |
| Organization Name | WILLIAM B. BOHANNAN DDS, MD, PC |
| Other Organization Name | WILLIAM B. BOHANNAN DDS, MD |
| Practice Address |
1750 El Camino Real Suite 403 Burlingame CA 94010-3228 |
| Practice Telephone | 6506921530 |
| Practice Fax Number | 6506922655 |
| Mailing Telephone | 6506921530 |
| Mailing Fax Number | 6506922655 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WILLIAM B BOHANNAN (PRESIDENT OWNER) |
| Authorized Official Telephone | 6506921530 |
| 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 |
A64471 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| William B. Bohannan DDS, MD | Doing Business As Name - Organization |
| Street Address |
1750 EL CAMINO REAL SUITE 403 |
| City | BURLINGAME |
| State | CA |
| Zip Code | 94010-3228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386647824 | Robert Richard Elliston | Ophthalmology | 1750 El Camino Real, Ste 103, Burlingame, CA 94010-3210 | 2005-05-28 |
| 1447709746 | William D. Zigrang, Md | Internal Medicine | 1750 El Camino Real, 202, Burlingame, CA 94010-3228 | 2016-09-27 |
| 1205296431 | Dr. Xie, Inc. | Obstetrics & Gynecology | 1750 El Camino Real, Ste 305, Burlingame, CA 94010-3228 | 2016-03-01 |
| 1861833899 | Yun Ying Shi | Internal Medicine | 1750 El Camino Real, Suite 202, Burlingame, CA 94010-3228 | 2013-07-06 |
| 1891138301 | Burlingame Surgical Center Inc | Clinic/Center | 1750 El Camino Real, Burlingame, CA 94010-3228 | 2013-04-15 |
| 1245570266 | Maridez Valencia Brinas | Nurse Practitioner | 1750 El Camino Real, Suite 202, Burlingame, CA 94010 | 2013-02-28 |
| 1811228778 | F. Tortorice, M.d. Professional Corporation | Internal Medicine | 1750 El Camino Real, Suite 301, Burlingame, CA 94010-3228 | 2010-01-15 |
| 1871757906 | Anthony Russo, M.d., Inc. | Internal Medicine | 1750 El Camino Real, Suite 301, Burlingame, CA 94010-3228 | 2008-07-17 |
| 1922275288 | Haichun Xie | Obstetrics & Gynecology | 1750 El Camino Real, Ste 305, Burlingame, CA 94010-3228 | 2008-05-14 |
| 1518134139 | Mid-peninsula Urology Group | Specialist | 1750 El Camino Real, Suite 307, Burlingame, CA 94010-3228 | 2008-05-13 |
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|---|---|---|---|---|
| 1568071850 | Jilla Lavian | Social Worker | 1240 Lakeview Drive, San Mateo, CA 94010 | 2020-07-23 |
| 1982246575 | Golden State Heart & Vascular Associates | Internal Medicine | 1850 El Camino Real Ste 200, Burlingame, CA 94010 | 2019-10-15 |
| 1184182248 | Primrose Healing and Wellness, Inc. | Marriage & Family Therapist | 405 Primrose Rd, #320, Burlingame, CA 94010 | 2019-03-07 |
| 1720508724 | Monazza Chaudhry | Pharmacist | 1828 El Camino Real #104, Burlingame, CA 94010 | 2017-06-21 |
| 1861804007 | Heidi Platt | Counselor | 826 Mahler Road, Burlingame, CA 94010 | 2014-05-22 |
| 1144662685 | Scarlett M Reyes | Counselor | 1818 Gilbreth Road, Suite 230, Womens Recovery Association, Burlingame, CA 94010 | 2013-07-25 |
| 1760821979 | Elliot Naidus | Internal Medicine | 1720 El Camino Real Ste 150, Burlingame, CA 94010 | 2013-06-20 |
| 1831430651 | Huddleston Care, LLC | In Home Supportive Care | 1364 Drake Avenue, Burlingame, CA 94010 | 2013-03-04 |
| 1891070843 | Linda Susan Notario | Pharmacist | 260 El Camino Raal, Burlingame, CA 94010 | 2011-10-20 |
| 1063794006 | Tram Anh Le | Pharmacist | 260 N El Camino Real, Burlingame, CA 94010 | 2011-09-15 |
| Find all providers in zip 94010 | ||||
| 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 |
|---|---|---|---|---|
| 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 | BURLINGAME |
| Zip Code | 94010 |
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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.