ESTEBAN D. BONILLA DDS PROFESSIONAL CORPORATION (NPI# 1356541361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356541361 |
| Entity Type | Organization |
| Organization Name | ESTEBAN D. BONILLA DDS PROFESSIONAL CORPORATION |
| Other Organization Name | COSMETIC IMPLANT GOLD DENTAL CENTER |
| Practice Address |
10745 Riverside Drive Suite B Toluca Lake CA 91602 |
| Practice Telephone | 8189802887 |
| Practice Fax Number | 8189802807 |
| Mailing Telephone | 8189802887 |
| Mailing Fax Number | 8189802807 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |
| Authorized Official Name | DR. ESTEBAN D BONILLA (DENTIST / OWNER) |
| Authorized Official Telephone | 8189802887 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
36135 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL PIN | B36135 | 01 |
| Other Name | Type Code |
|---|---|
| Cosmetic Implant Gold Dental Center | Doing Business As Name - Organization |
| Street Address |
10745 RIVERSIDE DRIVE SUITE B |
| City | TOLUCA LAKE |
| State | CA |
| Zip Code | 91602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114148723 | Esteban D Bonilla | Dentist | 10745 Riverside Drive, Suite B, Toluca Lake, CA 91602-2371 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679112882 | Da Oum Remnant Acupuncture Corporation | Acupuncturist | 10674 Riverside Drive, North Hollywood, CA 91602 | 2020-01-06 |
| 1043704927 | Brandi Carter | Nurse Practitioner | 10222 Camarillo St Apt 107, Toluca Lake, CA 91602 | 2018-06-14 |
| 1669904587 | Katelyn Story Kalstein | Naturopath | 11650 Riverside Dr., Ph-2a, Studio City, CA 91602 | 2017-03-30 |
| 1255781118 | Karla Morales | Dental Hygienist | 10707 Camarillo St, #305, West Toluca Lake, CA 91602 | 2016-06-21 |
| 1457738536 | Mallory Garrett | Marriage & Family Therapist | 10737 Riverside Dr, N Hollywood, CA 91602 | 2015-04-28 |
| 1831590322 | Victoria J. Chan | Nurse Practitioner | 4418 Vineland Avenue Suite 102, Toluca Lake, CA 91602 | 2014-09-16 |
| 1679916076 | Richard Villasenor | Ophthalmology | 10520 Camarillo St, Toluca Lake, CA 91602 | 2013-04-16 |
| 1275878233 | Julissa Trusty | Marriage & Family Therapist | 11334 Camarillo St, North Hollywood, CA 91602 | 2012-12-03 |
| 1265789531 | Marina Serobyan | Marriage & Family Therapist | 10999 Riverside Drive, Suite 306, Toluca Lake, CA 91602 | 2012-08-06 |
| 1407133457 | Hearing Aid Counselors, Inc | Durable Medical Equipment & Medical Supplies | 11008 Riverside Dr, Toluca Lake, CA 91602 | 2011-11-04 |
| Find all providers in zip 91602 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407188204 | Pema Dental Care | Clinic/Center | 10668 Riverside Dr, Toluca Lake, CA 91602-2319 | 2010-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093551 | Arshdeep Kaur Dental Corporation | Clinic/Center | 345 F St Ste 180, Chula Vista, CA 91910-2648 | 2020-11-08 |
| 1699376350 | Funto Ayanleke Dds | Clinic/Center | 1116 W Tokay St Ste A, Lodi, CA 95240-3852 | 2020-11-07 |
| 1427658541 | Anthony Ngo, Dmd Professional Corporation | Clinic/Center | 18361 Beach Blvd, Huntington Beach, CA 92648-1310 | 2020-10-28 |
| 1912507948 | Alexander Phillips Dds Inc | Clinic/Center | 120 C Ave Ste 100, Coronado, CA 92118-1992 | 2020-10-28 |
| 1912507203 | George K Nguyen Dds, PC | Clinic/Center | 2097 Compton Ave Ste 104, Corona, CA 92881-7289 | 2020-10-27 |
| 1316547524 | Ingersoll Park Marina Gp Dental Corporation | Clinic/Center | 2301 Park Marina Dr Ste 27, Redding, CA 96001-2158 | 2020-10-27 |
| 1396344073 | Charles Kim Dental Corporation | Clinic/Center | 15651 Imperial Hwy Ste 204, La Mirada, CA 90638-1653 | 2020-10-22 |
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1760081129 | Anthony Pham Dental Corp | Clinic/Center | 2658 E Garvey Ave S, West Covina, CA 91791-2113 | 2020-10-17 |
| 1215535182 | Park and Park Dental Group Partnership | Clinic/Center | 473 E Alessandro Blvd Ste A, Riverside, CA 92508-6021 | 2020-10-13 |
| Find all providers with the same taxonomy | ||||
| City | TOLUCA LAKE |
| Zip Code | 91602 |
Please comment or provide details below to improve the information on ESTEBAN D. BONILLA DDS PROFESSIONAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.