Active NPI
Gretchen Bruce, DDS
- Periodontics
- Oakland, CA
National Provider Identifier
1417167206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 35844
- Practice address
- 1624 Franklin Street
Suite 320
Oakland, CA 94612 - Phone
- (510) 268-8838
- Fax
- (510) 268-8611
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 35844 | CA | Primary |
Addresses
Primary practice location
1624 Franklin Street
Suite 320
Oakland, CA 94612
Mailing address
2155 Webster Street
Suite 526
San Francisco, CA 94115
Phone (415) 929-6542
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35844 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417167206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2155 WEBSTER STREET",
"address_2": "SUITE 526",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94115",
"telephone_number": "415-929-6542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1624 FRANKLIN STREET",
"address_2": "SUITE 320",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94612",
"telephone_number": "510-268-8838",
"fax_number": "510-268-8611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "GRETCHEN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "35844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, 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.