Individual provider Active NPI

Irene Bodjanac Bozir, D.D.S.

  • Dentist
  • Escondido, CA
National Provider Identifier
1659522811
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
42635 Issued in CA
Practice address
230 E 5TH Ave
Escondido, CA 92025-4906
Phone
(760) 738-9595
Fax
(760) 738-9596
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 42635 CA Primary

Addresses

Primary practice location

230 E 5TH Ave
Escondido, CA 92025-4906

Mailing address

2924 Capazo CT
Carlsbad, CA 92009-4407
Phone (760) 505-1588

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150623002644 CA Order and Referring Only - DentistPractitioner - Dentist 8527379197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42635CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Irene Bodjanac Bozir, D.D.S., Inc. Past Accepting new patients
Lotfali Yari DDS Inc. Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1659522811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 CAPAZO CT",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920094407",
            "telephone_number": "760-505-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 5TH AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254906",
            "telephone_number": "760-738-9595",
            "fax_number": "760-738-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZIR",
        "first_name": "IRENE",
        "middle_name": "BODJANAC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.