William B. Bohannan DDS, MD, PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

A64471 Issued in CA

Legal business name

WILLIAM B. BOHANNAN DDS, MD, PC

Practice address

1750 El Camino Real
Suite 403
Burlingame, CA 94010-3228

Phone

(650) 692-1530

Fax

(650) 692-2655

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William B Bohannan, D.D.S., M.D.NPI 1013077239

Title

President Owner

Phone

(650) 692-1530

Specialties & licenses 1

Addresses

Other names 1

• William B. Bohannan DDS, MD Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William B Bohannan, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Burlingame, CA
  • NPI 1013077239
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669533832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL",
            "address_2": "SUITE 403",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103228",
            "telephone_number": "650-692-1530",
            "fax_number": "650-692-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL",
            "address_2": "SUITE 403",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103228",
            "telephone_number": "650-692-1530",
            "fax_number": "650-692-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM B. BOHANNAN DDS, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOHANNAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "650-692-1530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "A64471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "William B. Bohannan DDS, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Dawson White, M.D.
• Frances-Anne Anonas White, MSN,RN,FNP
• Erik Joseph Wilk, MD
• Jeremy M Wilkinson, MD
• Andrew Scott Willard
• William D. Zigrang, MD
• Johnny Williams I
• Ross O Williams, DDS
• Sadie Elizabeth Williams
• Wilshire Healthcare Management and Investment, Inc.

• Oral and Maxillofacial Surgery Clinic/Center in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.