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CLELEN C. TANNER DDS INC NPI 1689991762


NPI Information

NPI: 1689991762
Provider Name: CLELEN C. TANNER, DDS, INC

Other Name: FOOTHILL DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
21911 FOOTHILL BLVD
HAYWARD, CA
ZIP 94541
Phone: (510) 733-1455
Get Directions

CLELEN C. TANNER, DDS, INC is a general practice dentist in Hayward, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CLELEN C. TANNER, DDS, INC NPI is 1689991762. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Foothill Dental.

The provider's business location address is:

21911 FOOTHILL BLVD
HAYWARD, CA
ZIP 94541-118
Phone: (510) 733-1455
Fax: (510) 889-8395

The provider's authorized official is Clelen C. Tanner .
The authorized official title is Owner and has the following contact phone number (510) 733-1455.

The enumeration date for this NPI number is 4/28/2010 and was last updated on 4/28/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice26003CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11215080445OTHERCALIFORNIANPI
2U89763MEDICARE UPINCALIFORNIA
3DC0260031MEDICARE UPINCALIFORNIA

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: 11/14/2023

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