JOHN MICHAEL BOZANICH DDS, MS
NPI 1629362363
Dentist - Periodontics in Santa Rosa, CA

Q: What is John Bozanich's NPI number?

The NPI number for John Bozanich is 1629362363. It was assigned to this individual provider in the NPPES registry on May 29, 2011.

Q: What is John Bozanich's specialty?

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

Q: Is John Bozanich enrolled in Medicare?

No. John Bozanich has opted out of Medicare through April 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for John Bozanich was last updated on January 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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 May 29, 2011Opted out of Medicare · through Apr 22, 2028

2305 MENDOCINO AVE, SANTA ROSA, CA 95403(707) 525-1500(707) 525-0315 Get Directions Write a Review

NPPES record last updated: January 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About John Michael Bozanich Dds, Ms NPPES

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

JOHN MICHAEL BOZANICH DDS, MS (NPI 1629362363) is an individual periodontics provider in Santa Rosa, California, licensed in California (103783) and active in the NPI registry since May 2011. He has opted out of Medicare through April 22, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1629362363

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameJOHN MICHAEL BOZANICHCredential: DDS, MS

Location Address2305 MENDOCINO AVESanta Rosa, CA 95403-3157

Mailing Address1822 Sherwood CtSanta Rosa, CA 95405-4660 · (281) 731-9403

Phone(707) 525-1500

Fax(707) 525-0315

Sole ProprietorNo

Enumeration DateMay 29, 2011

Last NPPES UpdateJanuary 12, 2023

NPPES CertifiedJanuary 12, 2023

✔ NPI 1629362363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

Licenses✔ Licensed in CA · 103783✔ Licensed in TX · 26498

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.

2305 MENDOCINO AVE, Santa Rosa, CA 95403

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

John Michael Bozanich Dds, Ms has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 22, 2026 through April 22, 2028.

Opt-Out Effective DateApril 22, 2026

Opt-Out In Effect ThroughApril 22, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$77.94 typical visit price

range $21.02 – $153.40

Typical copayment $19.48 (range $5.25 – $38.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVE & DONNA B. EAKIN

Occupational Therapist (Hand)

2305 MENDOCINO AVE, SUITE B
SANTA ROSA, CA 95403

Sonoma County (707) 544-2637

DR. HOLLIS LOREN STAVN O.D.

Optometrist

2305 MENDOCINO AVE, STE B
SANTA ROSA, CA 95403

Sonoma County (707) 527-9137

DR HOLLIS L STAVN O.D. AN OPTOMETRY CORPORATION

Optometrist

2305 MENDOCINO AVE, STE B
SANTA ROSA, CA 95403

Sonoma County (707) 527-9137

DR. MICHAEL WAYNE LAWSON D.C.

Chiropractor

2305 MENDOCINO AVE, SUITE B
SANTA ROSA, CA 95403

Sonoma County (707) 575-1700

HEATHER YVADNE ANDERSON D.D.S.

Dentist (General Practice)

2305 MENDOCINO AVE
SANTA ROSA, CA 95403

Sonoma County (707) 525-1500

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 John Bozanich's NPI number?

The NPI number for John Bozanich is 1629362363. It was assigned to this individual provider in the NPPES registry on May 29, 2011.

Where is John Bozanich located?

John Bozanich practices at 2305 Mendocino Ave, Santa Rosa, CA 95403. The listed phone number is (707) 525-1500.

What is John Bozanich's specialty?

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

Is John Bozanich enrolled in Medicare?

No. John Bozanich has opted out of Medicare through April 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does John Bozanich accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list John Bozanich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Bozanich was last updated on January 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.