Healthcare Provider Details

I. General information

NPI: 1013315514
Provider Name (Legal Business Name): CLAIRE FERRARI DDS, MSD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2014
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 ARLINGTON AVE
KENSINGTON CA
94707-1401
US

IV. Provider business mailing address

1940 SAN ANTONIO AVE
BERKELEY CA
94707-1620
US

V. Phone/Fax

Practice location:
  • Phone: 510-338-6000
  • Fax:
Mailing address:
  • Phone: 510-338-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number44875
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: