MEDICARE: MICHAEL BOUZID, DDS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1043161458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL BOUZID, DDS, INC

Provider Business Mailing Address
First Line	:	10430 S DE ANZA BLVD STE 120
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-3024
Country	:	US
Telephone Number	:	408-253-0153
Fax Number	:	408-253-0153

Provider Business Practice Location Address
First Line	:	10430 S DE ANZA BLVD STE 120
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-3024
Country	:	US
Telephone Number	:	408-253-0153
Fax Number	:	408-253-0153

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL BOUZID
Credential	:	DDS
Telephone Number	:	650-504-6740

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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