Lisa Louise Bozzetti, DDS
Individual provider Active NPI General Practice Dentistry · Hillsboro, OR
NPI 1487718243 · NPPES record last updated Apr 1, 2008
Key facts
- NPI
- 1487718243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D8149 (OR)
- Practice address
- 730 SE Oak St Ste a
Hillsboro, OR 97123-4245 - Phone
- (503) 352-2361
- Fax
- (503) 352-2363
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160223001311 | OR | Order and Referring Only - Dentist |
7315242864 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8149 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Garcia Memorial Health Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8149 | OR | Yes |
| General Practice Dentistry | 1223G0001X | 51232 | CA |
Addresses
Primary practice location
730 SE Oak St Ste a
Hillsboro, OR 97123-4245
Mailing address
730 SE Oak St Ste a
Hillsboro, OR 97123-4245
Phone (503) 352-2361
Other providers in Hillsboro, OR
- Ammie Lee Boyd
- Joshua Boyd
- Mikayla Boyd
- Tonya A Boyd
- Claire Boyer
- Wendy Brackeen
- Denice Bracken
- Nathan Brackenbury
- Jenny R Brady
- Kali Brady
All providers in Hillsboro, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.