Boones Creek Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BOONES CREEK DENTISTRY

Doing business as

Boones Creek Dentistry

Practice address

4328 N Roan St
Johnson City, TN 37615-4641

Phone

(423) 282-2441

NPI assigned

Feb 22, 2023

Last updated

Feb 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Gail Andrews

Title

Administrative Assistant

Phone

(423) 282-2441

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Boones Creek Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• J. Michael Amburgey, D.D.S.

  • General Practice Dentistry
  • Johnson City, TN
  • NPI 1326045238
  NPD (past)

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1124726724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154641",
            "telephone_number": "423-282-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4328 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154641",
            "telephone_number": "423-282-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONES CREEK DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "423-282-2441"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1255828356",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1326185471",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1568812691",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boones Creek Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bedford W. Bonta, MD
• Bethany Nicole Booher, FNP
• Samantha Bookbinder, MD
• Eric Bookout, MD
• Amanda F Boone, LPN
• Boones Creek Medical PLLC
• Boones Creek Pharmacy, Inc. (Boones Creek Pharmacy)
• Boones Creek Pharmacy, Inc.
• Sarah Elizabeth Boop, RN, MPH
• Teddy Wayne Booth II, LCSW

• General Practice Dentistry in Johnson City, TN
• Providers in Johnson City, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.