Healthcare Provider Details

I. General information

NPI: 1184643538
Provider Name (Legal Business Name): STEVEN JOHN BOUNDS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 SAND CANYON AVE SUITE 320
IRVINE CA
92618-3716
US

IV. Provider business mailing address

16100 SAND CANYON AVE SUITE 320
IRVINE CA
92618-3716
US

V. Phone/Fax

Practice location:
  • Phone: 949-857-1053
  • Fax: 949-857-4611
Mailing address:
  • Phone: 949-857-1053
  • Fax: 949-857-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number43422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: