Individual provider Active NPI

William Leo Gardner, DDS

  • General Practice Dentistry
  • Alameda, CA
National Provider Identifier
1093928798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37668 Issued in CA
Practice address
2241 Central Ave.
Suite B
Alameda, CA 94501-4430
Phone
(510) 865-4400
Fax
(510) 865-4417
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 37668 CA Primary

Addresses

Primary practice location

2241 Central Ave.
Suite B
Alameda, CA 94501-4430

Mailing address

2241 Central Ave.
Suite B
Alameda, CA 94501-4430
Phone (510) 865-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37668CAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093928798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 CENTRAL AVE.",
            "address_2": "SUITE B",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014430",
            "telephone_number": "510-865-4400",
            "fax_number": "510-865-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 CENTRAL AVE.",
            "address_2": "SUITE B",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014430",
            "telephone_number": "510-865-4400",
            "fax_number": "510-865-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "WILLIAM",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.