Stephen John Bosco, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

006087 Issued in CT

Practice address

1 Lake St
Suite 101
New Britain, CT 06052-1396

Phone

(860) 223-8107

Fax

(860) 223-1086

NPI assigned

Aug 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 26, 2016 through Jan 26, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225040884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAKE ST",
            "address_2": "SUITE 101",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521396",
            "telephone_number": "860-223-8107",
            "fax_number": "860-223-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAKE ST",
            "address_2": "SUITE 101",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521396",
            "telephone_number": "860-223-8107",
            "fax_number": "860-223-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCO",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "006087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "07803",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "020006087CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liana Marie Booker
• Amy Bopp, APRN
• Ovanes Halasan Borgonos, M.D.
• Robert Borkowski, MD
• Patrick Christopher Boscarino, PHARMD
• Allyson Bouchard
• Rebekka Boucher
• Anita L Bourque, MD
• Morgan Leigh Bowles
• Box of Rain Counseling Services, PLLC

• Oral and Maxillofacial Surgery (Dentist) in New Britain, CT
• Providers in New Britain, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.