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General NPI Number Information
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NPI Number | 1508902198
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Entity Type | Individual
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Provider Name | BONNIE MICHELLE BADII DDS
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 480 4TH AVE STE 314
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City | CHULA VISTA
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State | CA
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Zip | 91910-4403
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Country | US
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Telephone | 619-425-8060
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Fax |
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Provider Business Mailing Address
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Address Line | 1942 PORT CLARIDGE PL
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-6612
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Country | US
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Telephone | 619-961-7456
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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 | 53630
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License Number State | CA
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