Organization Active NPI

Robert a Bosque Jr DMD PC

  • General Practice Dentistry
  • Savannah, GA
National Provider Identifier
1063490365
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN009619 Issued in GA
Legal business name
ROBERT A BOSQUE JR DMD PC
Practice address
723 E 65TH St
Savannah, GA 31405-4408
Phone
(912) 355-0555
Fax
(912) 353-9042
NPI assigned
Jan 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Authorized official

Name
Dr. Robert Alexander Bosque Jr., D.M.D.
Title
President
Phone
(912) 355-0555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN009619 GA Primary

Addresses

Primary practice location

723 E 65TH St
Savannah, GA 31405-4408

Mailing address

723 E 65TH St
Savannah, GA 31405-4408
Phone (912) 355-0555

National Provider Directory

National Provider Directory

Locations

723 E 65th St
Savannah, GA 31405
Phone (912) 315-0555

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1063490365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 E 65TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054408",
            "telephone_number": "912-355-0555",
            "fax_number": "912-353-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 E 65TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054408",
            "telephone_number": "912-355-0555",
            "fax_number": "912-353-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A BOSQUE JR DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "BOSQUE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-355-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN009619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; 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.