DR. JUAN CARLOS BOSQUE SR. (NPI# 1750506754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750506754 |
Entity Type | Individual |
Full Name | DR. JUAN CARLOS BOSQUE SR. |
Credential | DDS |
Practice Address |
3760 Convoy St Suite 330 San Diego CA 92111-3742 |
Mailing Address |
5514 Bloch St San Diego CA 92122-4012 |
Practice Telephone | 8589995968 |
Mailing Telephone | 8589995968 |
Enumeration Date | 2007-04-16 |
Last Update Date | 2012-01-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223E0200X |
Dentist Specialization: Endodontics |
42723 | CA | Dental Providers |
Street Address |
3760 CONVOY ST SUITE 330 |
City | SAN DIEGO |
State | CA |
Zip Code | 92111-3742 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437159001 | Dorian L Polson | Psychologist | 3760 Convoy St, Ste 118, San Diego, CA 92111-3742 | 2005-07-26 |
1790217479 | Jennifer Howard | Speech-Language Pathologist | 3760 Convoy St, Suite 204, San Diego, CA 92111-3742 | 2017-03-31 |
1629518204 | Therese Azkoul | Occupational Therapist | 3760 Convoy St, Suite 204, San Diego, CA 92111-3742 | 2017-03-02 |
1245770866 | Carol Lieu | Physical Therapist | 3760 Convoy St, Suite 204, San Diego, CA 92111-3742 | 2017-03-01 |
1619416245 | Denise Martinez | Physical Therapist | 3760 Convoy St, Suite 101, San Diego, CA 92111-3742 | 2017-02-15 |
1750826426 | Christine Gaw | Occupational Therapist | 3760 Convoy St, Ste 201, San Diego, CA 92111-3742 | 2017-01-04 |
1154866259 | Alyssa Zafuta | Physical Therapist | 3760 Convoy St, Suite 100, San Diego, CA 92111-3742 | 2016-12-27 |
1134670011 | Therapy Specialists | Physical Therapist | 3760 Convoy St, Suite 204, San Diego, CA 92111-3742 | 2016-10-17 |
1477007961 | Cathy Mizunuma | Speech-Language Pathologist | 3760 Convoy St, Suite 204, San Diego, CA 92111-3742 | 2016-08-12 |
1225486376 | Rebecca Vandervolgen | Speech-Language Pathologist | 3760 Convoy St, Ste. 204, San Diego, CA 92111-3742 | 2016-05-31 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982220653 | Karen Elizabeth Mitchell | Registered Nurse | County of San Diego California Children's Services (ccs, 6991 Balboa Ave, (room 70), San Diego, CA 92111 | 2020-06-18 |
1912523804 | Access Medical, Inc. | Durable Medical Equipment & Medical Supplies | 4150 Convoy Street, Suite A, San Diego, CA 92111 | 2020-06-17 |
1154944551 | Mei Ling Milan Szeto | Student in an Organized Health Care Education/Training Program | 7917 Ostrow Street, Suite A, San Diego, CA 92111 | 2020-05-20 |
1346893831 | Leticia Isabel Peralta | Assistant Behavior Analyst | 563 Balboa Avenue. Number 521, San Diego, CA 92111 | 2019-07-23 |
1295204394 | Demetria Serfas | Behavioral Analyst | 563 Balboa Ave #521, San Diego, CA 92111 | 2018-11-19 |
1568981678 | Ross Psychology | Psychologist | 4883 Ronson Court, Suite K, San Diego, CA 92111 | 2017-09-11 |
1225554587 | Bianca Acosta | Technician, Other | 563 Balboa Ave. #521, San Diego, CA 92111 | 2017-08-18 |
1194240085 | Kazuhiro Kato | Dentist | 3707 Convoy St., San Diego, CA 92111 | 2017-08-11 |
1073038527 | Joanne Epps-yentz | Licensed Vocational Nurse | 7414 Mesa College Dr. Apt 47, San Diego, CA 92111 | 2017-08-06 |
1184158446 | Positive Behavior Supports Corp | Community/Behavioral Health | 563 Balboa Ave, 521, San Diego, CA 92111 | 2017-04-13 |
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Taxonomy Code | 1223E0200X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Endodontics |
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245716950 | Erik Balinghasay | Dentist | 12750 Carmel Country Rd Ste 201, San Diego, CA 92130-2171 | 2018-07-16 |
1770010795 | Elenaz Sarshar | Dentist | 6750 Beadnell Way Unit 49, San Diego, CA 92117-5148 | 2017-05-22 |
1174973507 | Duc Huynh Nguyen | Dentist | 5830 Oberlin Dr Ste 103, San Diego, CA 92121-3753 | 2016-06-16 |
1184004517 | Sheena Howell Dmd, Inc | Dentist | 522 Thorn St, San Diego, CA 92103-5710 | 2015-06-01 |
1457774192 | Anthony Potente | Dentist | 4033 3rd Ave Ste 303, San Diego, CA 92103-2117 | 2014-01-31 |
1306156823 | Kelvin Chou | Dentist | 5783 Mission Center Rd Apt 307, San Diego, CA 92108-4918 | 2010-10-18 |
1285942532 | Sean Daniels | Dentist | 9750 Miramar Rd Ste 375, San Diego, CA 92126-7503 | 2010-09-21 |
1891950937 | William A Walker | Dentist | 2615 Clairemont Dr, San Diego, CA 92117-6634 | 2008-07-28 |
1891966008 | Edward William Jerge | Dentist | 3762 Clairemont Dr, San Diego, CA 92117-5916 | 2008-03-14 |
1750570354 | Eugene Charles Hanson | Dentist | 4065 3rd Ave Ste 300, San Diego, CA 92103-2184 | 2007-10-18 |
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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.