Thomas Richard Bolten, D.D.S., MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901020176 Issued in MI

Practice address

6022 W Maple Rd Ste 405
West Bloomfield, MI 48322-4408

Phone

(248) 855-2006

Fax

(248) 855-0571

NPI assigned

May 11, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

Wayne State University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Oms P CGroup PAC ID 9739084559, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Michigan Oms P C

  • Oral and Maxillofacial Surgery (Dentist)
  • West Bloomfield, MI
  • NPI 1801906458
  Medicare reassignment Care Compare group
• Birmingham Oral & Maxillofacial Surgery, PLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Birmingham, MI
  • NPI 1598255044
  NPD

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1053545707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6022 W MAPLE RD STE 405",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224408",
            "telephone_number": "248-855-2006",
            "fax_number": "248-855-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6022 W MAPLE RD STE 405",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224408",
            "telephone_number": "248-855-2006",
            "fax_number": "248-855-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTEN",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901020176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bodyreformmd
• Erica Boettcher, MA, CCC-SLP
• Boggs P.C
• Lisa Bohra, MD
• Ashley Nicole Bolin, PT, DPT
• James Bombard
• Abby Simone Bonato, M.D.
• Karen Lehman Boren, P.T,
• David Borkowski
• Bormans Inc

• Oral and Maxillofacial Surgery (Dentist) in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.