NPIMap

Organization Active NPI

John C. Boain, DDS Dental Care, LLC

Doing business as Boain Dental Care

  • General Practice Dentistry
  • Florissant, MO
National Provider Identifier
1356811731
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JOHN C. BOAIN, DDS DENTAL CARE, LLC
Doing business as
Boain Dental Care
Practice address
1001 Dunn Rd
Florissant, MO 63031-8215
Phone
(314) 921-3527
Fax
(314) 921-7855
NPI assigned
Nov 28, 2018
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Authorized official

Name
Ty V. Justice
Title
Director, Payer Relations
Phone
(513) 808-4984

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1001 Dunn Rd
Florissant, MO 63031-8215

Mailing address

9825 Kenwood Rd Ste 200
Blue Ash, OH 45242-6252
Phone (513) 808-4984

Other names 1

  • Boain Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Boain Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1356811731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 KENWOOD RD STE 200",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452426252",
            "telephone_number": "513-808-4984",
            "fax_number": "513-448-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 DUNN RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318215",
            "telephone_number": "314-921-3527",
            "fax_number": "314-921-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. BOAIN, DDS DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "JUSTICE",
        "authorized_official_first_name": "TY",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "513-808-4984"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boain Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.