John E. Bosak Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38260 Issued in CA

Practice address

10727 White Oak Ave Ste 213
Granada Hills, CA 91344-4656

Phone

(818) 368-5676

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1164441838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10727 WHITE OAK AVE STE 213",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444656",
            "telephone_number": "818-368-5676",
            "fax_number": "818-368-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10727 WHITE OAK AVE STE 213",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444656",
            "telephone_number": "818-368-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSAK",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "38260",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.