Active NPI
Charlette Boykin, EFDA
- Dental Assistant
- Centerville, OH
National Provider Identifier
1184013989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- EFDA 01071
- Practice address
- 7058 Corporate Way Ste 3
Centerville, OH 45459-4243 - Phone
- (937) 586-7729
- NPI assigned
- Jan 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | EFDA 01071 | OH | Primary |
Addresses
Primary practice location
7058 Corporate Way Ste 3
Centerville, OH 45459-4243
Mailing address
5324 Rivers Edge Blvd
Dayton, OH 45414-3846
Phone (937) 825-7363
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| EFDA 01071 | OH | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421366400000",
"number": "1184013989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5324 RIVERS EDGE BLVD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454143846",
"telephone_number": "937-825-7363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7058 CORPORATE WAY STE 3",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454594243",
"telephone_number": "937-586-7729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYKIN",
"first_name": "CHARLETTE",
"credential": "EFDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-16",
"last_updated": "2015-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "OH",
"license": "EFDA 01071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.