Jeremy R. Bold, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47453 Issued in CA

Practice address

16625 Dove Canyon Rd
Suite 103
San Diego, CA 92127-3490

Phone

(858) 674-9999

Fax

(858) 674-0733

NPI assigned

Jul 21, 2006

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992726467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16625 DOVE CANYON RD",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273490",
            "telephone_number": "858-674-9999",
            "fax_number": "858-674-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16625 DOVE CANYON RD",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273490",
            "telephone_number": "858-674-9999",
            "fax_number": "858-674-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLD",
        "first_name": "JEREMY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liza L Bolanos
• Melissa Bolanos
• Zulma Yesenia Bolanos
• Divya S Bolar, M.D.
• Jennifer M Bold, AU.D
• Darlene Bolden
• Khylan Bolden
• Alyssa Boldt
• Brenna Kailyn Boldt
• Ryan William Bolduc

• 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 Jul 8, 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.