Lana Bubalo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105502 Issued in CA

Practice address

8430 Lemon Ave
La Mesa, CA 91941-5310

Phone

(619) 466-8363

NPI assigned

Sep 18, 2020

Last updated

Sep 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Stephen B Earle, DDS

  • General Practice Dentistry
  • La Mesa, CA
  • NPI 1629093570
  NPD (past)

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1699381285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5359 LA JOLLA BLVD UNIT 24",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377955",
            "telephone_number": "408-489-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 LEMON AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415310",
            "telephone_number": "619-466-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBALO",
        "first_name": "LANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Bruno
• Evan Bryan, HHP, MT
• Jeanine Bryan, P.T
• Bryant Nguyen, MD, PC
• Tamika Mims Bryant
• Morey Jack Bubis, MD
• Briggitte N Buchanan
• Mahealani Kim Buckler, RN, IBCLC
• Joseph Andrew Buckley, D.D.S.
• Kailey Grace Buckley

• Dentist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.