NPIMap

Organization Active NPI

Dr. Jennifer N. Boles, DDS, LLC

Doing business as Southern Smiles

  • General Practice Dentistry
  • Rayville, LA
National Provider Identifier
1225308398
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5050 Issued in LA
Legal business name
DR. JENNIFER N. BOLES, DDS, LLC
Doing business as
Southern Smiles
Practice address
902 Julia St
Rayville, LA 71269-2618
Phone
(318) 728-8773
Fax
(318) 728-8787
NPI assigned
Jan 6, 2012
Last updated
Mar 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Dr. Jennifer Newton BolesNPI 1386754620
Title
Owner
Phone
(318) 248-4986

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5050 LA Primary

Addresses

Primary practice location

902 Julia St
Rayville, LA 71269-2618

Mailing address

902 Julia St
Rayville, LA 71269-2618
Phone (318) 728-8773

Other names 1

  • Southern Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Jennifer N Boles DDS LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1225308398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 JULIA ST",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712692618",
            "telephone_number": "318-728-8773",
            "fax_number": "318-728-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 JULIA ST",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712692618",
            "telephone_number": "318-728-8773",
            "fax_number": "318-728-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JENNIFER N. BOLES, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "BOLES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NEWTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-248-4986",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rayville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.