Amanda Heydari Boisen, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

104420 Issued in CA

Practice address

6333 Telegraph Ave Ste 101
Oakland, CA 94609-1359

Phone

(510) 547-1300

NPI assigned

Apr 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evan R Santiago DDS MSD Inc

  • Periodontics
  • Oakland, CA
  • NPI 1649044835
  NPD

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1104406057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 SANTA ROSA AVE APT 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121963",
            "telephone_number": "650-464-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 TELEGRAPH AVE STE 101",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091359",
            "telephone_number": "510-547-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISEN",
        "first_name": "AMANDA",
        "middle_name": "HEYDARI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "104420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese L Bogan, MFT
• Julie Bogdanski, L.AC.
• Edna Jeannene Bohannon, PH.D., MFT
• Corey Morrow Bohman, RN, ANP
• Rebecca Ann Boice
• Jessica Bol
• Brendan Russell Boland
• Adriana Bolanos Juarez
• Elizabeth Bolanos-Hernandez
• Sofia Bolanos-Kellison

• Periodontics in Oakland, CA
• Providers in Oakland, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.