BOUDAIE DENTAL PC (NPI# 1306488341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306488341 |
| Entity Type | Organization |
| Organization Name | BOUDAIE DENTAL PC |
| Practice Address |
630 N Pacific Coast Hwy Ste 15 El Segundo CA 90245-3435 |
| Practice Telephone | 3103413041 |
| Practice Fax Number | 3103413328 |
| Mailing Telephone | 3103413041 |
| Mailing Fax Number | 3103413328 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | ALEX BOUDAIE (PRESIDENT) |
| Authorized Official Telephone | 3103413041 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Ruby Dental Care | Doing Business As Name - Organization |
| Street Address |
630 N PACIFIC COAST HWY STE 15 |
| City | EL SEGUNDO |
| State | CA |
| Zip Code | 90245-3435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366058976 | Britt'nee Cornelius | Massage Therapist | 222 North PCh, Suite 2000, El Segundo, CA 90245 | 2020-09-18 |
| 1750913778 | Laurie Ann Scoppetto | Dietitian, Registered | 482 N Aviation Blvd, El Segundo, CA 90245 | 2020-02-07 |
| 1972135283 | A Dabrowska Dds, Inc | Dentist | 390 N. Pacific Coast Hwy #1050, El Segundo, CA 90245 | 2020-02-05 |
| 1578023057 | Miles Bertumen | Pharmacist | 283 N Aviation Blvd, Building 210, El Segundo, CA 90245 | 2019-03-21 |
| 1831673201 | Kriss L. Killam | Marriage & Family Therapist | 302 W. Grand Ave., Suite 9, El Segundo, CA 90245 | 2018-09-20 |
| 1811487911 | Bright Light Recovery | Substance Abuse Rehabilitation Facility | 218 Concord St, Suite C, El Segundo, CA 90245 | 2018-05-14 |
| 1265950448 | Sarah Yuriko Mizuki | Physician Assistant | 390 N PCh, Suite 1000, El Segundo, CA 90245 | 2017-09-07 |
| 1326586462 | Jlp Interpreting Services | Interpreter | 963 Virginia St #5, El Segundo, CA 90245 | 2017-02-09 |
| 1619351707 | El Segundo Dermatology, Inc. | Specialist | 713 N Douglas St., El Segundo, CA 90245 | 2015-07-17 |
| 1083956635 | 24hr Homecare, LLC | Home Health | 200 N. Pacific Coast Highway, Suite 300, El Segundo, CA 90245 | 2013-03-21 |
| Find all providers in zip 90245 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972135283 | A Dabrowska Dds, Inc | Dentist | 390 N. Pacific Coast Hwy #1050, El Segundo, CA 90245 | 2020-02-05 |
| 1548707441 | Shepard & Dos Santos Dental Corporation | Dentist | 310 E Grand Ave Ste 102, El Segundo, CA 90245-3871 | 2017-01-30 |
| 1265981880 | The Cosmopolitan Dentis | Dentist | 390 N Sepulveda Blvd Ste 1050, El Segundo, CA 90245-4476 | 2016-09-23 |
| 1497146633 | Robert E Murphy | Dentist | 512 Main St Ste 4, El Segundo, CA 90245-3065 | 2015-02-10 |
| 1023264124 | Christopher Kim Duong | Dentist | 303 Kansas St Apt C, El Segundo, CA 90245-4464 | 2008-08-08 |
| 1497973879 | Gerhard Wutzke | Dentist | 222 N. Sepulveda Blvd., Suite 1800, El Segundo, CA 90245 | 2007-04-23 |
| 1154346054 | Sara Michelle Hale | Dentist | 505 W Maple Ave, El Segundo, CA 90245-2114 | 2006-07-12 |
| 1316940315 | Sandra Calleros | Dentist | 131 W Grand Ave, Suite B, El Segundo, CA 90245-3738 | 2005-05-23 |
| 1144617796 | Eileen Welch | Dentist | 483 N Aviation Blvd Bldg 210, El Segundo, CA 90245-2808 | 2015-04-22 |
| 1942601786 | Es Kaleka Dmd Inc | Dentist | 502 Center St, El Segundo, CA 90245-3201 | 2014-09-11 |
| Find all providers in EL SEGUNDO | ||||
| City | EL SEGUNDO |
| Zip Code | 90245 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.