Scott Craig Bohlke, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31207 Issued in CA

Practice address

5175 E. Pacific Coast Hwy.
Suite 401
Long Beach, CA 90804-3313

Phone

(562) 597-2461

NPI assigned

Aug 5, 2013

Sex

Male

Sole proprietor

Yes

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

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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1104258805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 E. PACIFIC COAST HWY.",
            "address_2": "SUITE 401",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043313",
            "telephone_number": "562-597-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5175 E. PACIFIC COAST HWY.",
            "address_2": "SUITE 401",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043313",
            "telephone_number": "562-597-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLKE",
        "first_name": "SCOTT",
        "middle_name": "CRAIG",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boghawala DDS Inc
• Jeffrey Bognot
• Nassim Bogsara, PSY D
• Deseree Deann Bohanan, MSW, LCSW
• Peter Alden Bohlig, BSN, RN
• Sarah Bohn
• Joshua D Bohrer, CMT
• Eugenie Boiadjieva, L.C.S.W.
• Jennifer Anne Boisvert, PH.D.
• Julijana Bojcevska

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.