JESMINE BOGHAWALA DDS INC. NPI 1033765870

NPI Information

NPI: 1033765870
Provider Name: JESMINE BOGHAWALA DDS INC.
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
10929 SOUTH ST STE 110B
CERRITOS, CA
ZIP 90703
Phone: (562) 860-6626
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JESMINE BOGHAWALA DDS INC. is a dental clinic center in Cerritos, CA. JESMINE BOGHAWALA DDS INC. NPI is 1033765870. The provider is registered as an organization entity type.

The provider's business location address is:

10929 SOUTH ST STE 110B
CERRITOS, CA
ZIP 90703-365
Phone: (562) 860-6626
Fax: (562) 860-6628

The provider's authorized official is Jesmine Boghawala .
The authorized official title is Dentist and has the following contact phone number (562) 860-6626.

The enumeration date for this NPI number is 8/16/2019 and was last updated on 8/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	302R00000X	Health Maintenance Organization				No
2	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1235486143	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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