Bohle Family Dentistry, PSC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BOHLE FAMILY DENTISTRY, PSC

Practice address

1836 Broadway St
Paducah, KY 42001-2708

Phone

(270) 442-0256

Fax

(270) 442-8730

NPI assigned

May 24, 2010

Last updated

May 24, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles J Bohle, D.M.D.NPI 1922010974

Title

President

Phone

(270) 442-0256

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Joseph Bohle Jr., D.M.D.

  • Dentist
  • Paducah, KY
  • NPI 1922010974
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1003135534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012708",
            "telephone_number": "270-442-0256",
            "fax_number": "270-442-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012708",
            "telephone_number": "270-442-0256",
            "fax_number": "270-442-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOHLE FAMILY DENTISTRY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "BOHLE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-442-0256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60056371",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blayne Allyssa Bogard
• Sarah Bogard
• Kevin Lee Boggess, LCSW
• Anthony L Bohannon, PT
• Michelle Bohanon, RPH, BCPS
• Charles Joseph Bohle Jr., D.M.D.
• Maria M Bokeno
• Anita Diane Bolin
• Roy Thomas Bolin II, DMD
• Bon Secours Mercy Health Virtual Care LLC (Mercy Health - Virtual Care)

• Dental Clinic/Center in Paducah, KY
• Providers in Paducah, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.