Tab A. Boyle, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36862 Issued in CA

Practice address

44950 Valley Central Way
#1-107
Lancaster, CA 93536-7209

Phone

(661) 940-6350

Fax

(661) 942-3541

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective May 3, 2016 through May 3, 2028

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 and National Provider Directory roles.

• Dr. Tab a. Boyle

  • Health Maintenance Organization
  • Lancaster, CA
  • NPI 1295907517
  NPD (past)
• Tab a Boyle DDS

  • General Practice Dentistry
  • Lancaster, CA
  • NPI 1689021255
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750437299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44950 VALLEY CENTRAL WAY",
            "address_2": "#1-107",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935367209",
            "telephone_number": "661-940-6350",
            "fax_number": "661-942-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44950 VALLEY CENTRAL WAY",
            "address_2": "#1-107",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935367209",
            "telephone_number": "661-940-6350",
            "fax_number": "661-942-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "TAB",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Carla Bower, IBCLC
• Staci Nicole Bowie
• Amaya Boyd
• Bradford Moore Boyd Jr., DDS
• John Boyd
• Gerardo Bozikovic Jr.
• Carla Marie Onglengco Bozon, MD
• Bradford Boyd, DDS, Inc
• Monique Valmajean Bradford-McCree
• Paul Martin Bradford, RRW

• General Practice Dentistry in Lancaster, CA
• Providers in Lancaster, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.