SUSAN A BOLLINGER DDS NPI 1538601117

NPI Information

NPI: 1538601117
Provider Name: SUSAN A BOLLINGER DDS

Doing Business As: BAYSHORE DENTAL GROUP

Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
1401 AVOCADO AVE STE 309
NEWPORT BEACH, CA
ZIP 92660
Phone: (949) 759-7007
Get Directions

SUSAN A BOLLINGER DDS is a customized equipment durable medical equipment medical supplies in Newport Beach, CA. SUSAN A BOLLINGER DDS NPI is 1538601117. The provider is registered as an organization entity type.
The provider Is Doing Business As Bayshore Dental Group.

The provider's business location address is:

1401 AVOCADO AVE STE 309
NEWPORT BEACH, CA
ZIP 92660-733
Phone: (949) 759-7007

The provider's authorized official is Nancy Marie Kennon .
The authorized official title is Office Manager and has the following contact phone number (949) 759-7007.

The enumeration date for this NPI number is 11/14/2016 and was last updated on 11/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	26589	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7560010001	OTHER	CALIFORNIA	PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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