Neila Nicholson Bouchard, D.M.D.
Individual provider Active NPI Dentist · Milton, FL
NPI 1225520810 · NPPES record last updated Jan 18, 2022
Key facts
- NPI
- 1225520810
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 23362 (FL)
- Practice address
- 5908 Berryhill Rd
Milton, FL 32570-8294 - Phone
- (850) 623-0137
- NPI assigned
- May 31, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23362 | FL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 23362 | FL | Yes |
Addresses
Primary practice location
5908 Berryhill Rd
Milton, FL 32570-8294
Mailing address
5908 Berryhill Rd
Milton, FL 32570-8294
Other providers in Milton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.