Bruce Jeffrey Newman, DDS
Individual provider Active NPI Dentist · Colma, CA
NPI 1972515039 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972515039
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 27547 (CA)
- Practice address
- 4939 Junipero Serra BL
Colma, CA 94014-3216 - Phone
- (650) 755-4050
- Fax
- (650) 755-4056
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27547 | CA | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27547 | CA | Yes |
Addresses
Primary practice location
4939 Junipero Serra BL
Colma, CA 94014-3216
Mailing address
4939 Junipero Serra BL
Colma, CA 94014-3216
Phone (650) 755-4050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27547 | Other | CA | DDS |
| 528451 | Other | UNITED CONCORDIA | |
| B27547-01 | Medicaid | CA |
Other providers in Colma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.