NPIMap

Organization Active NPI

Bo Lee Macdonald DDS Inc

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1548647944
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36955 Issued in CA
Legal business name
BO LEE MACDONALD DDS INC
Practice address
11340 W Olympic Blvd
Suite 148
Los Angeles, CA 90064-1608
Phone
(310) 479-4459
Fax
(310) 477-9239
NPI assigned
May 5, 2015
Last updated
May 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Bo Lee Macdonald, DDSNPI 1144347360
Title
Owner/President
Phone
(310) 479-4459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36955 CA Primary

Addresses

Primary practice location

11340 W Olympic Blvd
Suite 148
Los Angeles, CA 90064-1608

Mailing address

11340 W Olympic Blvd
Suite 148
Los Angeles, CA 90064-1608
Phone (310) 479-4459

National Provider Directory

National Provider Directory

Locations

11340 W Olympic Blvd
Ste 148
Los Angeles, CA 90064
Phone (310) 479-4459

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1548647944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11340 W OLYMPIC BLVD",
            "address_2": "SUITE 148",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641608",
            "telephone_number": "310-479-4459",
            "fax_number": "310-477-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 W OLYMPIC BLVD",
            "address_2": "SUITE 148",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641608",
            "telephone_number": "310-479-4459",
            "fax_number": "310-477-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BO LEE MACDONALD DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "BO",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "310-479-4459",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.