Boston Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13904 Issued in MD

Legal business name

BOSTON DENTAL GROUP

Practice address

4701 Randolph Rd Ste 115
Rockville, MD 20852-2260

Phone

(301) 770-7710

NPI assigned

Nov 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline You

Title

President

Phone

(301) 770-7710

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1265733059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE 115",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522260",
            "telephone_number": "301-770-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE 115",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522260",
            "telephone_number": "301-770-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "YOU",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-770-7710",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Willis Boslego, M.S., OTR/L
• Roseann Bosley
• Sara Bosley, PT,DPT
• Kimberly Renee Johnson Bossie
• Ersilia Bostian, LCPC
• Kameesha Boston
• Thelma Boswell
• John M Bosworth Jr., M.D.
• Brenda Botchway
• Jennifer George Botros

• General Practice Dentistry in Rockville, MD
• Providers in Rockville, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.