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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