NPIMap

Organization Active NPI

Auburn Family Dentistry PLLC

  • General Practice Dentistry
  • Auburn, NH
National Provider Identifier
1003834045
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1870 Issued in NH
Legal business name
AUBURN FAMILY DENTISTRY PLLC
Practice address
7 Raymond Rd
Auburn, NH 03032-0425
Phone
(603) 483-8123
Fax
(603) 483-8127
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Authorized official

Name
Dr. Richard Bolduc, DMDNPI 1477747285
Title
Sr. Dentist
Phone
(603) 483-8123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1870 NH Primary

Addresses

Primary practice location

7 Raymond Rd
Auburn, NH 03032-0425

Mailing address

PO Box 425
Auburn, NH 03032-0425
Phone (603) 483-8123

Other identifiers 4

IdentifierTypeStateIssuer
30313402MedicaidNH
30306440MedicaidNH
81192076MedicaidNH
30319916MedicaidNH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1003834045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "AUBURN",
            "state": "NH",
            "postal_code": "030320425",
            "telephone_number": "603-483-8123",
            "fax_number": "603-483-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 RAYMOND RD",
            "city": "AUBURN",
            "state": "NH",
            "postal_code": "030320425",
            "telephone_number": "603-483-8123",
            "fax_number": "603-483-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "BOLDUC",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "SR. DENTIST",
        "authorized_official_telephone_number": "603-483-8123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "1870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30313402",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30306440",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81192076",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30319916",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.