Editha Legaspi Boongaling, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40653 Issued in CA

Practice address

2900 Sonoma Blvd
Suite a
Vallejo, CA 94590

Phone

(707) 552-8684

Fax

(707) 552-2980

NPI assigned

Sep 27, 2006

Sex

Female

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)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Day Dental Office, Apc

  • General Practice Dentistry
  • Vallejo, CA
  • NPI 1336328525
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1366533358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SONOMA BLVD",
            "address_2": "SUITE A",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945903810",
            "telephone_number": "707-552-8684",
            "fax_number": "707-552-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 SONOMA BLVD",
            "address_2": "SUITE A",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94590",
            "telephone_number": "707-552-8684",
            "fax_number": "707-552-2980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Sutter St Rm 1426",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941084010",
            "country_code": "US",
            "telephone_number": "415-434-3088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOONGALING",
        "first_name": "EDITHA",
        "middle_name": "LEGASPI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40653",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Castillo Bonifacio, D.D.S.
• Galadriel Ann Bonnel, RN, MSN, FNP
• Evelyne Yuvette Bonton Kelly
• Latisha Booker
• Boomers Medical Transportation, Inc.
• Peter P. Boorstein, MD
• Madhusudan Borde, MD
• Maria S Borres, FNP
• Breonna Bouie
• Andrew Thomas Bove

• General Practice Dentistry in Vallejo, CA
• Providers in Vallejo, 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 Dec 17, 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.