Provider Demographics
NPI:1730607813
Name:BOJORQUEZ LEDESMA, XOCHIPILLI (DDS)
Entity type:Individual
Prefix:MRS
First Name:XOCHIPILLI
Middle Name:
Last Name:BOJORQUEZ LEDESMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 EXECUTIVE SQUARE
Mailing Address - Street 2:STE 200
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-9123
Mailing Address - Country:US
Mailing Address - Phone:619-488-3200
Mailing Address - Fax:866-272-6924
Practice Address - Street 1:GARZA ST #160
Practice Address - Street 2:
Practice Address - City:LOS ALGODONES
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:21972
Practice Address - Country:MX
Practice Address - Phone:526-585-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ5798689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist