Susan a Bollinger DDS

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

26589 Issued in CA

Legal business name

SUSAN A BOLLINGER DDS

Doing business as

Bayshore Dental Group

Practice address

1401 Avocado Ave Ste 309
Newport Beach, CA 92660-8733

Phone

(949) 759-7007

NPI assigned

Nov 14, 2016

Last updated

Nov 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nancy Marie Kennon

Title

Office Manager

Phone

(949) 759-7007

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bayshore Dental Group Doing business as

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1538601117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE STE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608733",
            "telephone_number": "949-759-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE STE 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608733",
            "telephone_number": "949-759-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN A BOLLINGER DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "KENNON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-759-7007"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "26589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "7560010001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayshore Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Surgical Oasis Institute
• Surgicare of la Veta, LTD. (Newport Coast Surgical Institute)
• Surinder Saini MD Inc
• Kelly Surratt, PT, DPT
• Survivors LLC
• Susan a. Bollinger, DDS, Inc. (Bayshore Dental Group)
• Susan Ha Wellness and Chiropractic Corp (Anew Wellness)
• Susan Park Allen MD Inc
• Janine Gail Suvak, M.D.
• Taiga Suzuki, D.C

• Customized Equipment (DME) in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.