=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689867202
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOINA PANAITE DDS, MS, BS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2007
-----------------------------------------------------
Last Update Date | 06/08/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 450 SUTTER ST SUITE 2336
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94108-4206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-986-4664
-----------------------------------------------------
Fax | 415-986-1798
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 450 SUTTER ST SUITE 2336
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94108-4206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-986-4664
-----------------------------------------------------
Fax | 415-986-1798
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0300X
-----------------------------------------------------
Taxonomy Name | Periodontics
-----------------------------------------------------
License Number | 51368
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------