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General NPI Number Information
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NPI Number | 1912090945
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Entity Type | Organization
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Legal Business Name | UCSF BUCHANAN COMMUNITY DENTAL CENTER CL #8
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 100 BUCHANAN ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-6147
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Country | US
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Telephone | 415-476-5608
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Fax | 415-476-0408
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Provider Business Mailing Address
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Address Line | 100 BUCHANAN ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-6147
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Country | US
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Telephone | 415-476-5608
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Fax | 415-476-0408
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Authorized Official
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Title or Position | DEAN, SCHOOL OF DENTISTRY
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Name | DR. MICHAEL REDDY
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Credential | DMD,DMSC
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Telephone | 415-476-1323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2090
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2101
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2076
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2032
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License Number State | CA
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