Provider Demographics
NPI:1487020194
Name:BAY AREA DENTAL IMPLANT CENTER, LP
Entity Type:Organization
Organization Name:BAY AREA DENTAL IMPLANT CENTER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-283-0313
Mailing Address - Street 1:6161 MARGARIDO DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1838
Mailing Address - Country:US
Mailing Address - Phone:925-283-0313
Mailing Address - Fax:925-283-6818
Practice Address - Street 1:895 MORAGA RD
Practice Address - Street 2:SUITE 11
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-5094
Practice Address - Country:US
Practice Address - Phone:925-283-0313
Practice Address - Fax:925-283-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223P0300X, 1223S0112X
CA530631223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty