Kyung Lee Boen, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

52181 Issued in CA

Practice address

1786 Avenida Regina
San Marcos, CA 92069

Phone

(760) 212-2276

NPI assigned

Jul 14, 2005

Reactivated

Mar 22, 2006

Last updated

Mar 17, 2019By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1942209770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 AVENIDA REGINA",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920694209",
            "telephone_number": "760-212-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 AVENIDA REGINA",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "92069",
            "telephone_number": "760-212-2276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Frazee Road, #209",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921080000",
            "country_code": "US",
            "telephone_number": "619-574-6678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 Frazee Road, #209",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921080000",
            "country_code": "US",
            "telephone_number": "619-574-6678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEN",
        "first_name": "KYUNG",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2019-03-17",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Steele Bohline, PHD
• Ann Cottrell Bolander, MD
• Ryan Bond
• Kimberly A Bonn

• Dentist in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2019; 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.