Blue Apple Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

55913 Issued in CA

Legal business name

BLUE APPLE DENTAL, LLC

Practice address

6420 Commerce Blvd
Rohnert Park, CA 94928-2421

Phone

(707) 795-4523

NPI assigned

Jul 21, 2015

Organization subpart

No

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

Authorized official

Name

Anthony Lieu, DMD

Title

Owner

Phone

(707) 795-4523

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1942685896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 COMMERCE BLVD",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 COMMERCE BLVD",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282421",
            "telephone_number": "707-795-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE APPLE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "LIEU",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-795-4523",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "55913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Bettencourt
• Michael Joseph Bird, DDS
• Jocelyn Miguel Bishop, SLP
• Aaron Vance Blackledge, M.D.
• Shauna M Blanquie, ATC
• Chris Bongardt, MFT
• Fernando Boria Gonzalez, MD
• Amber Lynn Bowman
• Bianca Marie Boyajian
• Caleb Boyer

• Dental Clinic/Center in Rohnert Park, CA
• Providers in Rohnert Park, 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 Sep 3, 2015; 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.