Individual provider Active NPI

Sean Franklin Bardsley, D.D.S.

  • General Practice Dentistry
  • San Mateo, CA
National Provider Identifier
1164529012
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46556 Issued in CA
Practice address
36 N San Mateo Dr
Suite a
San Mateo, CA 94401-4522
Phone
(650) 344-5111
NPI assigned
Sep 20, 2006
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 46556 CA Primary

Addresses

Primary practice location

36 N San Mateo Dr
Suite a
San Mateo, CA 94401-4522

Mailing address

36 N San Mateo Dr
Suite a
San Mateo, CA 94401-4522
Phone (650) 344-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 16, 2015 through Jun 16, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46556CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Darren Machule DMD PHD Past Accepting new patients
Ronald C K Jew DDS Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164529012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 N SAN MATEO DR",
            "address_2": "SUITE A",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944014522",
            "telephone_number": "650-344-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N SAN MATEO DR",
            "address_2": "SUITE A",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944014522",
            "telephone_number": "650-344-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDSLEY",
        "first_name": "SEAN",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.