Eric Budiman, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

61985 Issued in CA

Practice address

11816 Garvey Ave
El Monte, CA 91732-3312

Phone

(626) 780-4932

NPI assigned

Mar 17, 2015

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1417340274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11816 GARVEY AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323312",
            "telephone_number": "626-780-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11816 GARVEY AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323312",
            "telephone_number": "626-780-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDIMAN",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-17",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE60541145",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "61985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Evan Bruker, LCSW
• Laura Brumby
• George Bryant
• Elena Jaklin Budagyan, PA-C
• Amanda Budiman, DDS, MS
• Herman Budiman, D.D.S.
• Nereida Buenrostro
• Selestina Bugarin I
• Kenneth G Burgdorff, P.T.
• Kyle Stephen Burnard

• Orthodontics and Dentofacial Orthopedics Dentistry in El Monte, CA
• Providers in El Monte, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.