Active NPI
Kaely Minati Bolio, DDS
- Dentist
- Oxford, MI
National Provider Identifier
1316730799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901602575APP25
- Practice address
- 830 S Lapeer Rd Ste a
Oxford, MI 48371-6514 - Phone
- (248) 628-9557
- NPI assigned
- May 27, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901602575APP25 | MI | Primary |
Addresses
Primary practice location
830 S Lapeer Rd Ste a
Oxford, MI 48371-6514
Mailing address
5645 Golf Pointe Dr
Clarkston, MI 48348-5148
Phone (586) 907-1209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901602575APP25 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748304000000",
"number": "1316730799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5645 GOLF POINTE DR",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483485148",
"telephone_number": "586-907-1209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 S LAPEER RD STE A",
"city": "OXFORD",
"state": "MI",
"postal_code": "483716514",
"telephone_number": "248-628-9557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLIO",
"first_name": "KAELY",
"middle_name": "MINATI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-27",
"last_updated": "2025-05-27",
"certification_date": "2025-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901602575APP25",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.