Randolph Anthony Borquez, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30082 Issued in CA

Practice address

12440 Firestone Blvd
Suite 1018
Norwalk, CA 90650-4328

Phone

(562) 863-4333

Fax

(562) 863-0533

NPI assigned

Dec 28, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770649337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12440 FIRESTONE BLVD",
            "address_2": "SUITE 1018",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504328",
            "telephone_number": "562-863-4333",
            "fax_number": "562-863-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 FIRESTONE BLVD",
            "address_2": "SUITE 1018",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504328",
            "telephone_number": "562-863-4333",
            "fax_number": "562-863-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORQUEZ",
        "first_name": "RANDOLPH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B30082-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "CA00XXXXX49940000000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Bloemeke
• Michelle Boedeker
• Amanda Joy Boer, LCSW
• Maryam Booth
• Josephine N Borgonia, MSW
• Samia S Boshra, MD
• Zakaria T Boshra
• Myra Botello, M.A.
• Fawzy S Botros
• Rick Bottoms

• General Practice Dentistry in Norwalk, CA
• Providers in Norwalk, 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 9, 2007; 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.