Individual provider Active NPI

David Rossi Boschken, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Jose, CA
National Provider Identifier
1063584019
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
48088 Issued in CA
Practice address
6128 Camino Verde Drive
Suite D
San Jose, CA 95119-1432
Phone
(408) 225-6660
Fax
(408) 225-5504
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 48088 CA Primary

Addresses

Primary practice location

6128 Camino Verde Drive
Suite D
San Jose, CA 95119-1432

Mailing address

6128 Camino Verde Drive
Suite D
San Jose, CA 95119-1432
Phone (408) 225-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
48088CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063584019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 CAMINO VERDE DRIVE",
            "address_2": "SUITE D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191432",
            "telephone_number": "408-225-6660",
            "fax_number": "408-225-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6128 CAMINO VERDE DRIVE",
            "address_2": "SUITE D",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191432",
            "telephone_number": "408-225-6660",
            "fax_number": "408-225-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCHKEN",
        "first_name": "DAVID",
        "middle_name": "ROSSI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "48088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.