Boulevard Dental Associates, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN12326 Issued in FL

Legal business name

BOULEVARD DENTAL ASSOCIATES, LLC

Practice address

10794 Pines Blvd Ste 204
Pembroke Pines, FL 33026-3920

Phone

(954) 538-9993

Fax

(954) 538-9994

NPI assigned

Jun 13, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Claudio Hernandez, DDS

Title

Doctor

Phone

(954) 538-9993

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Boulevard Dental Associates, llc Former legal business name

Locations

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1154814143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD STE 204",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-538-9993",
            "fax_number": "954-538-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD STE 204",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-538-9993",
            "fax_number": "954-538-9994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10794 Pines Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330263920",
            "country_code": "US",
            "telephone_number": "954-538-9993",
            "fax_number": "954-538-9994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5370 Palm Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330122766",
            "country_code": "US",
            "telephone_number": "305-821-9022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOULEVARD DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "CLAUDIO",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "954-538-9993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN12326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1427594258",
            "identifier": "1427594258",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulevard Dental Associates, llc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Daile Bortner, APRN
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• Carolina Bou
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• Michel Bourgeois, LMT
• Adriana Bovee, LMHC
• Sara Bowden, PT, DPT
• Eve Mandisa Rader Bowers, MD
• Joseph P. Bowers, M.D.

• Dental Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.