Jessica Leigh Bogucki, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

010957 Issued in CT

Practice address

921 State St
New Haven, CT 06511-3926

Phone

(203) 865-2245

NPI assigned

Jun 19, 2012

Last updated

Nov 26, 2024By the provider in NPPES

Sex

Female

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 CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jennifer Y. You, DMD, LLC

  dba Levy Dental Group

  • Dentist
  • New Haven, CT
  • NPI 1265853832
  NPD (past)
• Levy Dental Group, P.C.

  • Prosthodontics
  • New Haven, CT
  • NPI 1093729071
  NPD (past)

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1083977672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084734",
            "telephone_number": "860-391-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 STATE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113926",
            "telephone_number": "203-865-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUCKI",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "010957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Murphy Bogardus, P.T.
• Sidney T Bogardus Jr., MD
• Eliyahu Bogart, LMHC
• Ian Bogdanowicz, MD
• Lauren Veronica Boggs
• Mary S Bogucki, MD
• Clifford W Bogue, MD
• Jesse Bohrer-Clancy, M.D.
• Daniel Boiarsky, MD
• Zachary Boivin

• Dentist in New Haven, CT
• Providers in New Haven, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.