Provider Demographics
NPI:1023283025
Name:WILLIAMTENNANTDDS/WILLIAMGIANNIDDS
Entity type:Organization
Organization Name:WILLIAMTENNANTDDS/WILLIAMGIANNIDDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:GIANNI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-848-3143
Mailing Address - Street 1:2999 REGENT ST
Mailing Address - Street 2:SUITE 714
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2146
Mailing Address - Country:US
Mailing Address - Phone:510-848-3143
Mailing Address - Fax:510-848-2522
Practice Address - Street 1:2999 REGENT ST
Practice Address - Street 2:SUITE 714
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2146
Practice Address - Country:US
Practice Address - Phone:510-848-3143
Practice Address - Fax:510-848-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty