Faith Aftreth Bolam, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

34584 Issued in CA

Practice address

7557 El Cajon Blvd
Suite B
La Mesa, CA 91941-8623

Phone

(619) 337-2970

Fax

(619) 460-5822

NPI assigned

May 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134339468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7557 EL CAJON BLVD",
            "address_2": "SUITE B",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919418623",
            "telephone_number": "619-337-2970",
            "fax_number": "619-460-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7557 EL CAJON BLVD",
            "address_2": "SUITE B",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919418623",
            "telephone_number": "619-337-2970",
            "fax_number": "619-460-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAM",
        "first_name": "FAITH",
        "middle_name": "AFTRETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "34584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Misty Diane Bonta, LEP

• Dentist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Dentist in California

• 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.