BOCA DENTAL PREMIER NPI 1306721931

NPI Information

  • NPI: 1306721931
  • Provider Name: BOCA DENTAL PREMIER
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 2018 LAKE TAHOE BLVD
    SOUTH LAKE TAHOE, CA
    ZIP 96150
  • Phone: (702) 703-1590

Map and Directions

Get Directions

NPI Details

BOCA DENTAL PREMIER is a dental clinic center in South Lake Tahoe, CA. BOCA DENTAL PREMIER NPI is 1306721931. The provider is registered as an organization entity type.

The provider's business location address is:

2018 LAKE TAHOE BLVD
SOUTH LAKE TAHOE, CA
ZIP 96150-402
Phone: (702) 703-1590

The provider's authorized official is Mary Wilcox .
The authorized official title is Director Of Billing and has the following contact phone number (702) 703-1590.

The enumeration date for this NPI number is 8/11/2025 and was last updated on 9/5/2025.

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
1261QD0000XClinic/CenterDentalYes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI