Individual provider Active NPI

Anastasia Boduch

  • Dental Hygienist
  • Cincinnati, OH
National Provider Identifier
1134829393
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
Practice address
411 Oak St
Cincinnati, OH 45219-2504
Phone
(513) 984-1800
Fax
(513) 984-4909
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X Primary

Addresses

Primary practice location

411 Oak St
Cincinnati, OH 45219-2504

Mailing address

Sterling Medical Associates Attn : Credentials
411 Oak St
Cincinnati, OH 45219
Phone (513) 984-1800

Other identifiers 1

IdentifierTypeStateIssuer
OPTIONALOtherCOAST GUARD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Adult Day Services PastSince Mar 12, 2023 Accepting new patients
Sterling Medical Associates PastSince Mar 12, 2023 Accepting new patients

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": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1134829393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STERLING MEDICAL ASSOCIATES ATTN : CREDENTIALS",
            "address_2": "411 OAK ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45219",
            "telephone_number": "513-984-1800",
            "fax_number": "513-984-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 OAK ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192504",
            "telephone_number": "513-984-1800",
            "fax_number": "513-984-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODUCH",
        "first_name": "ANASTASIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COAST GUARD",
            "identifier": "OPTIONAL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.