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General NPI Number Information
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NPI Number | 1194639484
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Entity Type | Individual
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Provider Name | CHRISTOPHER ANTHONY BOGHDADY DDS
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Gender | Male
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 3030 HARBOR BLVD STE G1
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City | COSTA MESA
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State | CA
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Zip | 92626-2562
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Country | US
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Telephone | 714-546-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 27882 HOMESTEAD RD
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-3763
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Country | US
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Telephone | 949-910-3533
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS113351
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License Number State | CA
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