Robert Bootehsaz DMD Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

56953 Issued in CA

Legal business name

ROBERT BOOTEHSAZ DMD INC

Practice address

19458 Ventura Blvd Ste 10
Tarzana, CA 91356-3037

Phone

(818) 304-8021

Fax

(818) 304-8029

NPI assigned

Jun 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Robert Bootehsaz, DMDNPI 1932375300

Title

Owner

Phone

(818) 304-8021

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Bootehsaz, DMD

  • Dentist
  • Tarzana, CA
  • NPI 1932375300
  NPD (past) Authorized official

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1689087199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19458 VENTURA BLVD. STE 10",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563042",
            "telephone_number": "818-304-8021",
            "fax_number": "818-304-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19458 VENTURA BLVD STE 10",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563037",
            "telephone_number": "818-304-8021",
            "fax_number": "818-304-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT BOOTEHSAZ DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "BOOTEHSAZ",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-304-8021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "56953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephen M Robert, MD
• Shermaine Robertson, BEHAVIORAL THERAPIST
• Clifford Robinson Jr., L.M.F.T

• Dental Clinic/Center in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.