Jordan Randall Boland, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

063307 Issued in NY

Practice address

2108 W State St
Olean, NY 14760-1952

Phone

(716) 373-1210

NPI assigned

Mar 28, 2022

Last updated

Sep 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1063162352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 W STATE ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601952",
            "telephone_number": "716-373-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 W STATE ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601952",
            "telephone_number": "716-373-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "JORDAN",
        "middle_name": "RANDALL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063307",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Blinn
• Peter Timothy Bliss, DMD
• Board of Education (Olean City School District)
• Joseph Patrick Bohan, M.D.
• Ryan Bohn, ATC
• Amy Jo Booth
• Mary Kay Booth, BA, CASAC, LMHC
• Sara Lynn Bouch, LMSW
• Nicole Bower
• Lauren Bowser, PHARM.D.

• Dentist in Olean, NY
• Providers in Olean, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.