Boulevard Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2822 Issued in PR

Legal business name

BOULEVARD DENTAL CENTER

Practice address

Boulevard Ave. #3327 Levittown
Toa Baja, PR 00949

Phone

(787) 784-5229

Fax

(787) 721-3639

NPI assigned

Jan 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Lissette Morales, DMD

Title

Dentist

Phone

(787) 473-4154

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1396015335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOULEVARD AVE. #3327 LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "787-784-5229",
            "fax_number": "787-721-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BOULEVARD AVE. #3327 LEVITTOWN",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "787-784-5229",
            "fax_number": "787-721-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "787-473-4154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Vanessa Bonafont
• Angelica Marie Bonilla Tanon, PSYD
• Boricua Ambulance, Inc.
• Boriken Medical Services
• Evelyn Borrero
• Boulevard Health Care Program
• Boulevard Visual Clinic
• Ruth Nydia Burgos
• Carlos A Buxo Tirado, MD
• Yamil Angel Caceres, LND,CND

• General Practice Dentistry in Toa Baja, PR
• Providers in Toa Baja, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.