Boulevard Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59655 Issued in CA

Legal business name

BOULEVARD DENTAL

Practice address

939 E Palmdale Blvd
Palmdale, CA 93550-4711

Phone

(661) 937-7747

NPI assigned

May 10, 2018

Last updated

Nov 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Gobrial, DDSNPI 1518273846

Title

President

Phone

(818) 268-2448

Specialties & licenses 1

Addresses

Locations

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.

• David Gobrial, DDS

  • General Practice Dentistry
  • Palmdale, CA
  • NPI 1518273846
  NPD Authorized official

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1568952901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504711",
            "telephone_number": "661-937-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "GOBRIAL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-268-2448",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laelah Borroel
• Louie Enrique Borrrayo Jr.
• Cynthia M Borzaga, MS., CF-SLP
• Justus Boshoff, B.SC., B.PHARM
• Mary Boules
• Robert Bowen, OTR
• Sharon J Bowers, RD
• Buck Erickson Bowman, DC
• Boxidara, Inc.
• Tonette Boyd, SUDCCII

• General Practice Dentistry in Palmdale, CA
• Providers in Palmdale, 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 Nov 1, 2022; 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.