Individual provider Active NPI

Joel Garcia Boss

  • Dentist
  • Bradenton, FL
National Provider Identifier
1073929147
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21673 Issued in FL
Practice address
8441 Heritage Green Way
Bradenton, FL 34212-1400
Phone
(941) 741-8888
Fax
(941) 741-8903
NPI assigned
Jul 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN21673 FL
Dentist 122300000X DN21673 FL Primary

Addresses

Primary practice location

8441 Heritage Green Way
Bradenton, FL 34212-1400

Mailing address

6403 4TH St E
Bradenton, FL 34203-6001
Phone (786) 499-1236

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
DN21673FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Garcia Boss DMD P.a CurrentSince Jun 21, 2020 Accepting new patients
College Plaza Dental Center Dentist Past Accepting new patients

Locations

8441 Heritage Green Way
Bradenton, FL 34212
Phone (941) 405-3367

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1073929147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6403 4TH ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342036001",
            "telephone_number": "786-499-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 HERITAGE GREEN WAY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342121400",
            "telephone_number": "941-741-8888",
            "fax_number": "941-741-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA BOSS",
        "first_name": "JOEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN21673",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.