NPIMap

Organization Active NPI

Stephen P. Boger, DDS, PA

  • Dentist
  • Plymouth, MN
National Provider Identifier
1164758199
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D8092 Issued in MN
Legal business name
STEPHEN P. BOGER, DDS, PA
Practice address
2720 Annapolis Circle
Suite a
Plymouth, MN 55441
Phone
(763) 546-7707
Fax
(763) 546-7713
NPI assigned
Oct 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Authorized official

Name
Dr. Stephen P. Boger, D.D.S.
Title
President/Owner
Phone
(763) 546-7707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D8092 MN Primary

Addresses

Primary practice location

2720 Annapolis Circle
Suite a
Plymouth, MN 55441

Mailing address

2720 Annapolis Circle
Suite a
Plymouth, MN 55441
Phone (763) 546-7707

Other names 1

  • Boger Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2720 Annapolis Cir N
Unit A
Plymouth, MN 55441
Phone (763) 546-7701

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1164758199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 ANNAPOLIS CIRCLE",
            "address_2": "SUITE A",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "763-546-7707",
            "fax_number": "763-546-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 ANNAPOLIS CIRCLE",
            "address_2": "SUITE A",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "763-546-7707",
            "fax_number": "763-546-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN P. BOGER, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "BOGER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "763-546-7707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D8092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boger Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.