Individual provider Active NPI

John Charles Boykin III, DDS

  • Dentist
  • Parker, AZ
National Provider Identifier
1316538812
Registry record updated Aug 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.026353 Issued in OH
Practice address
12033 Agency Rd
Parker, AZ 85344-7718
Phone
(928) 669-2137
Fax
(928) 669-3353
NPI assigned
Jan 28, 2021
Last updated
Aug 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.026353 OH Primary

Addresses

Primary practice location

12033 Agency Rd
Parker, AZ 85344-7718

Mailing address

PO Box 95461
Cleveland, OH 44101-0033
Phone (928) 669-2137

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250915000179 TX Practitioner - Dentist 7315440336 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12033 Agency Rd
Parker, AZ 85344-7718

PO Box
Suite 95461
Cleveland, OH 44101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.026353OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix CurrentSince Aug 1, 2025 Accepting new patients
DHHS IHS Phoenix Area Current Accepting new patients
DHHS IHS Phoenix Area CurrentSince Sep 8, 2025 Accepting new patients
Irene Benn Medical Center CurrentSince Aug 1, 2025 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Aug 1, 2025 Accepting new patients

Locations

12033 Agency Rd
Parker, AZ 85344
Phone (760) 572-4137

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756598400000",
    "number": "1316538812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95461",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441010033",
            "telephone_number": "928-669-2137",
            "fax_number": "928-669-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 AGENCY RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447718",
            "telephone_number": "928-669-2137",
            "fax_number": "928-669-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYKIN",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2025-08-31",
        "certification_date": "2025-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, AZ

Sources for this page

Verify at the official NPI Registry.