Kathleen Jo Bohr, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS-09700 Issued in IA

Practice address

3308 Kimball Ave
Waterloo, IA 50702-5758

Phone

(319) 233-6177

NPI assigned

Aug 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Benjamin R. Squires, D.D.S.

  • General Practice Dentistry
  • Waterloo, IA
  • NPI 1477225845

  General Practice

  NPD

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1013563303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 SUNSET",
            "city": "HUDSON",
            "state": "IA",
            "postal_code": "506432224",
            "telephone_number": "563-203-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025758",
            "telephone_number": "319-233-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHR",
        "first_name": "KATHLEEN",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bohr@gosouthridge.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3308 Kimball Ave",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507025758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven D Boeke, O.D.
• Vinko M Bogdanic, M.D.
• Kayln Marie Boge-Kleiss, ARNP
• Allison Katherine Bohlman, MS, RD, LD
• Jane Kristine Bohnenkamp, MA CCCA
• Sierra Boike-Thompson
• Deanne K Bolhuis, A.R.N.P.
• Samira Bolic
• Kate Elizabeth Bolick, ARNP
• William C Bolick, D.D.S.

• All providers in Waterloo, IA
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.