Individual provider · Type 1 NPI
Amanda Heydari Boisen, DDS
Periodontics · Oakland, CA
NPI number
1104406057
Active
Practice location
6333 Telegraph Ave Ste 101
Oakland, CA 94609-1359
Mailing address
315 Santa Rosa Ave Apt 3
San Francisco, CA 94112-1963
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | 104420 (CA) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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- Paul Robert Rhodes, DDS, MSDPeriodontics Oakland, CA NPI 1407086242
- Glenn M. Fujinaka, DDSPeriodontics Oakland, CA NPI 1407953151
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About NPI 1104406057
Amanda Heydari Boisen, DDS's National Provider Identifier is 1104406057, issued on Apr 13, 2021. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Oakland, CA. The record was last updated on Oct 24, 2025.