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Organization
JESMINE BOGHAWALA DDS INC.
Active
Organization
JESMINE BOGHAWALA DDS INC.
Active
Other names
Innovative Smiles, Innovative Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESMINE BOGHAWALA DDS (DENTIST)
(562) 860-6626
Entity
Organization
Contact information
Practice address
13017 ARTESIA BLVD SUITE D120, CERRITOS, CA 90703-5365
(562) 860-6626
Mailing address
10929 SOUTH ST STE 110B, CERRITOS, CA 90703-5365
(562) 860-6626
(562) 860-6628
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235486143
—
CA
Enumeration date
08/16/2019
Last updated
04/09/2026
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