William Michael Bolak, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

17551 Issued in TX

Practice address

5509 Pleasant Valley Dr
Suite 700
Plano, TX 75023-5248

Phone

(972) 964-3636

Fax

(972) 519-0127

NPI assigned

Oct 18, 2006

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

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1255412979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 PLEASANT VALLEY DR",
            "address_2": "SUITE 700",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235248",
            "telephone_number": "972-964-3636",
            "fax_number": "972-519-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 PLEASANT VALLEY DR",
            "address_2": "SUITE 700",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235248",
            "telephone_number": "972-964-3636",
            "fax_number": "972-519-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAK",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "17551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Bockelman, NP
• Candice N Boehm, LPC
• Nilkanth R Bohre
• Carlena M Boike, SLP
• Tina Boike
• Benjamin Jang Bolding, PHARM D
• Andrew C. Bolin, MD
• Shannon C Bolinger, PA
• Lilian Inutu Bollers, LCSW-C, LICSW
• Jacqueline Bolt, MD

• Endodontics in Plano, TX
• Providers in Plano, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.