William P Boggess, D.M.D.

Individual provider Active NPI General Practice Dentistry · Jbphh, HI

NPI 1295706265 · NPPES record last updated Dec 13, 2023

Key facts

NPI
1295706265
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6934 (KY)
Practice address
480 Central Ave
Jbphh, HI 96860-4908
Phone
(808) 473-3430
NPI assigned
Jan 30, 2006
Sex
Male
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

LicenseStateTypeSpecialty
6934KYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology Dentistry 1223X0008X 6934 KY
General Practice Dentistry 1223G0001X 6934 KY Yes

Addresses

Primary practice location

480 Central Ave
Jbphh, HI 96860-4908

Mailing address

480 Central Ave
Pearl Harbor, HI 96860-4908
Phone (808) 473-3430

Other practice location 1

113 Obrien St
Greenville, KY 42345-1513
Phone (270) 338-4410

Other identifiers

IdentifierTypeStateIssuer
844023OtherKYUNITED CONCORDIA
YD29OtherKYBCBS FEDERAL
60069341MedicaidKY

Other providers in Jbphh, HI

All providers in Jbphh, HI · General Practice Dentistry in Hawaii

Sources for this page

Verify at the official NPI Registry.