Suzanne Lee Boynton, D.D.S.

Individual provider Active NPI General Practice Dentistry · Sonora, CA

NPI 1295873776 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295873776
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
43423 (CA)
Practice address
940 Sylva LN
Suite C
Sonora, CA 95370-5969
Phone
(209) 532-6931
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Opted out of Medicare
Yes, effective Jul 30, 2015 through Jul 30, 2027

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
43423CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43423 CA Yes

Addresses

Primary practice location

940 Sylva LN
Suite C
Sonora, CA 95370-5969

Mailing address

940 Sylva LN
Suite C
Sonora, CA 95370-5969
Phone (209) 532-6931

Other providers in Sonora, CA

All providers in Sonora, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.