Soraya Bouzida, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45827 Issued in CA

Practice address

4765 Carmel MTN Rd
#209
San Diego, CA 92130-6657

Phone

(858) 481-0080

Fax

(866) 734-3727

NPI assigned

May 1, 2007

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

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1962623793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 CARMEL MTN RD",
            "address_2": "#209",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306657",
            "telephone_number": "858-481-0080",
            "fax_number": "866-734-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 CARMEL MTN RD",
            "address_2": "#209",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306657",
            "telephone_number": "858-481-0080",
            "fax_number": "866-734-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUZIDA",
        "first_name": "SORAYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rathaphone Lesley Boutah, LCSW
• Amy Linnea Boutelle, RN, WHNP
• Adriana Boutte
• Lara R. Bouve, FNP - B.C.
• Michael Bouvet, M.D.
• Jessica Megan Bova, IDC
• Ruth Gabriela Bovey
• Brian Bovino, M.A., BCBA
• Kathryn M Bovino, M.A., B.C.B.A.
• Danielle Boward, RD

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 Sep 2, 2016; 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.