NPIMap

Organization Active NPI

Alex Boudaie, DDS Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1205297280
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ALEX BOUDAIE, DDS INC.
Doing business as
Pearl Dental Care
Practice address
11955 W Washington Blvd Apt 106
Los Angeles, CA 90066-5892
Phone
(310) 237-5747
Fax
(310) 237-5988
NPI assigned
Mar 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Authorized official

Name
Alex Boudaie, DDSNPI 1053750133
Title
President
Phone
(310) 237-5747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

11955 W Washington Blvd Apt 106
Los Angeles, CA 90066-5892

Mailing address

11955 W Washington Blvd Apt 106
Los Angeles, CA 90066-5892
Phone (310) 237-5747

Other names 1

  • Pearl Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

11955 W Washington Blvd
Ste 106
Los Angeles, CA 90066
Phone (310) 237-5747

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1205297280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11955 W WASHINGTON BLVD APT 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665892",
            "telephone_number": "310-237-5747",
            "fax_number": "310-237-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11955 W WASHINGTON BLVD APT 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665892",
            "telephone_number": "310-237-5747",
            "fax_number": "310-237-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX BOUDAIE, DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "BOUDAIE",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-237-5747",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearl Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pearl Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.