Matthew Richard Boufford, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

102646 Issued in CA

Practice address

2310 Craven St BLDG 3230
San Diego, CA 92136-5596

Phone

(619) 532-7935

NPI assigned

Jun 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1073008470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 TURQUOISE ST APT D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921091211",
            "telephone_number": "562-544-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 CRAVEN ST BLDG 3230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921365596",
            "telephone_number": "619-532-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUFFORD",
        "first_name": "MATTHEW",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Bouchard
• David Alan Boucher, PH.D.
• Josie Marie Boucher
• Ronald J Boucher, M.D.
• Martin Gabriel Boudrias, RN
• Angela Katherine Bougetz, PHARM.D.
• Genevieve Boulais, MA CCC-SLP
• Daniel Lee Bouland, M.D.
• Marc Patrick Boulanger II, DNP, PMHNP-BC
• Meagan Bouldin, RN BSN

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.