DR. AMANDA HEYDARI BOISEN DDS
NPI 1104406057
Dentist - Periodontics in Oakland, CA

Q: What is Amanda Boisen's NPI number?

The NPI number for Amanda Boisen is 1104406057. It was assigned to this individual provider in the NPPES registry on April 13, 2021.

Q: What is Amanda Boisen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Boisen was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 13, 2021

6333 TELEGRAPH AVE STE 101, OAKLAND, CA 94609(510) 547-1300 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Amanda Heydari Boisen Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AMANDA HEYDARI BOISEN DDS (NPI 1104406057) is an individual periodontics provider in Oakland, California, licensed in California (104420) and active in the NPI registry since April 2021.

NPPES Registry Identity

NPI1104406057

Entity TypeIndividualFemale

Primary Taxonomy1223P0300X

Provider Legal NameDR. AMANDA HEYDARI BOISENCredential: DDS

Location Address6333 TELEGRAPH AVE STE 101Oakland, CA 94609-1359

Mailing Address315 Santa Rosa Ave Apt 3San Francisco, CA 94112-1963 · (650) 464-5405

Phone(510) 547-1300

Sole ProprietorYes

Enumeration DateApril 13, 2021

Last NPPES UpdateOctober 24, 2025

NPPES CertifiedOctober 24, 2025

✔ NPI 1104406057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in CA · 104420

Definition

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.

6333 TELEGRAPH AVE STE 101, Oakland, CA 94609

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Boisen's NPI number?

The NPI number for Amanda Boisen is 1104406057. It was assigned to this individual provider in the NPPES registry on April 13, 2021.

Where is Amanda Boisen located?

Amanda Boisen practices at 6333 Telegraph Ave Ste 101, Oakland, CA 94609. The listed phone number is (510) 547-1300.

What is Amanda Boisen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Amanda Boisen was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.