Bouquet Dental Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BOUQUET DENTAL INC

Practice address

8003 Alicante Ave
Lamont, CA 93241-1712

Phone

(661) 845-2246

NPI assigned

Dec 16, 2018

Organization subpart

No

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

Authorized official

Name

Soo T Park, DDS

Title

President

Phone

(661) 845-2246

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544918400000",
    "number": "1679044861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 ALICANTE AVE",
            "city": "LAMONT",
            "state": "CA",
            "postal_code": "932411712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8003 ALICANTE AVE",
            "city": "LAMONT",
            "state": "CA",
            "postal_code": "932411712",
            "telephone_number": "661-845-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUQUET DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SOO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-845-2246",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fatima C Barrena Vazquez
• Beraldo Moises Barrios, MSW
• Anas Baytamouny, PHARMACIST
• Fernando Bocanegra, AMFT
• Jennifer Carolina Bonilla
• Beant Kaur Brar
• Jonathan Santos Cabral, LMFT
• Stanley Calderwood, MD
• Clarissa Cano
• Carlos a. Alvarez MD a Medical Group

• Dentist in Lamont, CA
• Providers in Lamont, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.