Individual provider Active NPI

Atanas Bogatinov, DMD

  • Dentist
  • Highland, IN
National Provider Identifier
1063016814
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12014866A Issued in IN
Practice address
Elite Dental of Highland, 2327 45TH Street
Highland, IN 46322
Phone
(219) 924-1193
NPI assigned
Nov 23, 2020
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12014866A IN Primary
Dentist 122300000X DN1860029 MA

Addresses

Primary practice location

Elite Dental of Highland, 2327 45TH Street
Highland, IN 46322

Mailing address

1001 S State St
Chicago, IL 60605-2226
Phone (631) 965-3631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12014866AINMDDentist
DN1860029MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist PastSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1063016814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052226",
            "telephone_number": "631-965-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELITE DENTAL OF HIGHLAND, 2327 45TH STREET",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "46322",
            "telephone_number": "219-924-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGATINOV",
        "first_name": "ATANAS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-23",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014866A",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1860029",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.