Organization Active NPI

UCSF Oral & Maxillofacial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Francisco, CA
National Provider Identifier
1679652598
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
UCSF ORAL & MAXILLOFACIAL SURGERY
Practice address
513 Parnassus Ave
Box 0476
San Francisco, CA 94143-2205
Phone
(415) 476-3242
Fax
(415) 476-0665
NPI assigned
Nov 2, 2006
Last updated
Oct 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
Dr. John D Featherstone, PHD
Title
Interim Dean
Phone
(415) 476-8997

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

513 Parnassus Ave
Box 0476
San Francisco, CA 94143-2205

Mailing address

513 Parnassus Ave
Box 0476
San Francisco, CA 94143-2205
Phone (415) 476-3242

Other identifiers 1

IdentifierTypeStateIssuer
GR0041990MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325001597 CA Part B Supplier - Clinic/Group Practice 1254223126 Receives reassigned benefits from 34 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3835 Cypress Dr
Ste 203
Petaluma, CA 94954
Phone (707) 766-7668

513 Parnassus Ave
#476
San Francisco, CA 94143
Phone (415) 476-3242

513 Parnassus Ave
#S722
San Francisco, CA 94143

513 Parnassus Ave
Ste 476
San Francisco, CA 94143

513 Parnassus Ave
Ste C646
San Francisco, CA 94143

513 Parnassus Ave
Ste S722
San Francisco, CA 94143
Phone (415) 476-2045

513 Parnassus Ave
Ste S738
San Francisco, CA 94143

521 Parnassus Ave
Rm C522
San Francisco, CA 94143
Phone (415) 476-1316

521 Parnassus Ave
Ste C522
San Francisco, CA 94143

521 Parnassus Ave
Ste C646
San Francisco, CA 94143

533 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-7192

533 Parnassus Ave
#8
San Francisco, CA 94143

533 Parnassus Ave
#S722
San Francisco, CA 94143

533 Parnassus Ave
Rm UB10
San Francisco, CA 94143

707 Parnassus Ave
Fl 1
San Francisco, CA 94143

707 Parnassus Ave
Rm D3214
San Francisco, CA 94143

707 Parnassus Ave
Ste D1050
San Francisco, CA 94143

707 Parnassus Ave
Ste D1147
San Francisco, CA 94143

707 Parnassus Ave
Ste D3000
San Francisco, CA 94143
Phone (415) 476-1731

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1679652598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVE",
            "address_2": "BOX 0476",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205",
            "telephone_number": "415-476-3242",
            "fax_number": "415-476-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVE",
            "address_2": "BOX 0476",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205",
            "telephone_number": "415-476-3242",
            "fax_number": "415-476-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCSF ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "FEATHERSTONE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "INTERIM DEAN",
        "authorized_official_telephone_number": "415-476-8997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0041990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.