McKenzie Rae Bocklet

Primary specialty

DentistTaxonomy code 122300000X

License

9915 Issued in SC

Practice address

1859 Savage Road
Charleston, SC 29407-4726

Phone

(843) 722-5733

NPI assigned

Jun 9, 2021

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1265009948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 SAVAGE ROAD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074726",
            "telephone_number": "843-722-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 SAVAGE ROAD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074726",
            "telephone_number": "843-722-5733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "497 W Butternut Rd",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294835585",
            "country_code": "US",
            "telephone_number": "843-970-7299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOCKLET",
        "first_name": "MCKENZIE",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry Wade Boatwright, M.D.
• John G Boatwright, MD
• Sarah Wade Boatwright, MD
• Alexi Madison Bobba, PA
• Jacob Bobba, PA
• Michael Thomas Bocklet, DMD, MSD
• Raymond Cary Bocklet, DMD, MS
• Robert Bocknek, DC
• Brooke Noelle Bode, DMD
• Jeffrey Bodle, MD

• Dentist in Charleston, SC
• Providers in Charleston, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.