David A Bogacz, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2019 Issued in NH

Practice address

197 Sanborn Rd
Tilton, NH 03276-5732

Phone

(603) 496-1683

Fax

(603) 286-7060

NPI assigned

Jul 17, 2006

Last updated

Nov 10, 2023By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI

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

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.

• Kristen E. Harvey DDS, LLC

  dba White Park Dental

  • General Practice Dentistry
  • Concord, NH
  • NPI 1174157770
  NPD (past)
• White Park Dental PLLC

  • General Practice Dentistry
  • Concord, NH
  • NPI 1497197024
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1144248337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "TILTON",
            "state": "NH",
            "postal_code": "032760206",
            "telephone_number": "603-496-1683",
            "fax_number": "603-286-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 SANBORN RD",
            "city": "TILTON",
            "state": "NH",
            "postal_code": "032765732",
            "telephone_number": "603-496-1683",
            "fax_number": "603-286-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGACZ",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "2019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000799",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "000180773",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "020390199",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280364",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadia Beaurivage, PHARMD, RPH
• Belknap Occupational Health LLC (Merrimack Valley Occupational Health and Coppola Physical Therapy)
• Esther Bertolami
• Bio-Medical Applications of New Hampshire, Inc. (Fresenius Kidney Care Lakes Region)
• BJS Wholesale Club Inc
• Setareh Bouzari, PHARMD
• Mallory Belanger Bruneau
• Christi Nicole Campbell, ABA
• Charles Edward Carter Jr.
• Concord Orthopaedics Professional Association

• General Practice Dentistry in Tilton, NH
• Providers in Tilton, NH by specialty
• General Practice Dentistry in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.