Ramona Georgeta Bosma, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

2008023543 Issued in MO

Practice address

13035 Olive Blvd
Suite 214
Creve Coeur, MO 63141-6173

Phone

(314) 205-0111

NPI assigned

Aug 5, 2008

Sex

Female

Sole proprietor

Yes

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.

• Kellen and Ramona Bosma DMD PC

  • Dental Clinic/Center
  • Sycamore, IL
  • NPI 1932585528
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 19, 2016 through Apr 19, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2008.

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1043476443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13035 OLIVE BLVD",
            "address_2": "SUITE 214",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416173",
            "telephone_number": "314-205-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 OLIVE BLVD",
            "address_2": "SUITE 214",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416173",
            "telephone_number": "314-205-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSMA",
        "first_name": "RAMONA",
        "middle_name": "GEORGETA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2008023543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Young Ho Bok, DC
• David Gerard Boland, M.ED., L.P.C.
• Jaclyn Bolzenius, M. A.
• Bradley Elliott Borello, OD
• Abby Christine Boron, SLP
• Brian Douglass Bourbon, CERTIFIED PEDORTHIST
• Tonya K Bourn, O.D.
• Loren Nicole Boushey, COTA/L
• Nancy Claire Bradley, R.D., L.D., C.D.E.
• Gregory H Branham, MD

• All providers in Creve Coeur, MO
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.