| M Elder D D S A Professional Corporation | |
|
2150 Appian Way Ste 201 Pinole Oral Surgery Pinole CA 94564-2520 | |
| (510) 724-3922 | |
| (510) 724-1037 |
| Full Name | M Elder D D S A Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 2150 Appian Way Ste 201, Pinole, California |
| Authorized Official Name and Position | Mahr Fairuke Elder (PRESIDENT / CEO) |
| Authorized Official Contact | 4158921190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M Elder D D S A Professional Corporation 140 Admiral Callaghan Lane Ste B Vallejo CA 94591 Ph: (415) 892-1190 | M Elder D D S A Professional Corporation 2150 Appian Way Ste 201 Pinole Oral Surgery Pinole CA 94564-2520 Ph: (510) 724-3922 |
| NPI Number | 1760633341 |
|---|---|
| Provider Enumeration Date | 10/01/2008 |
| Last Update Date | 08/18/2016 |
| Medicare PECOS PAC ID | 7810290350 |
|---|---|
| Medicare Enrollment ID | O20160907001070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760633341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 46586 (California) | Primary |
| Provider Name | Mahr Elder |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841301371 PECOS PAC ID: 3173762465 Enrollment ID: I20150702000586 |
| Provider Name | Lewis Clayman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992799613 PECOS PAC ID: 8426078163 Enrollment ID: I20160106001417 |
| Provider Name | David E Webb |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1255359469 PECOS PAC ID: 3678885357 Enrollment ID: I20161223000376 |
| Provider Name | James Edwards |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1609914209 PECOS PAC ID: 2365725900 Enrollment ID: I20170206002655 |
| Provider Name | William B Bohannan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1013077239 PECOS PAC ID: 2466757927 Enrollment ID: I20200113001553 |
| Provider Name | Willard Osibin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1205178357 PECOS PAC ID: 4688977135 Enrollment ID: I20200217004250 |
| Provider Name | Jaleh Tina Keyhani |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043214448 PECOS PAC ID: 6608203732 Enrollment ID: I20200229000110 |
Michael J.h. Mcdonald Dmd,inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1430 Tara Hills Dr, Suite B, Pinole, CA 94564 Phone: 510-724-5064 Fax: 510-724-1887 | |
Pinole Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1310 Tara Hills Dr Ste F, Pinole, CA 94564 Phone: 510-724-6900 Fax: 510-724-2707 | |
Kourosh Harandi Dds. Ms. Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Tara Hills Dr, Suite 202, Pinole, CA 94564 Phone: 510-724-3666 Fax: 510-724-5923 | |
Pinole Valley Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2830 Pinole Valley Rd Ste C, Pinole, CA 94564 Phone: 510-334-1593 | |
Pinole Modern Dentistry Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 Fitzgerald Dri, Pinole, CA 94564 Phone: 510-210-8907 Fax: 510-379-7252 | |
Carolyn L. Yu, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1430 Tara Hills Dr, Suite C, Pinole, CA 94564 Phone: 510-724-8001 | |
Shayan Bayat, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Tara Hills Dr, Suite 104, Pinole, CA 94564 Phone: 510-724-7474 |