Jody H. Boyles, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3465 Issued in WV

Practice address

711 N Pike St
Grafton, WV 26354-1221

Phone

(304) 265-4600

Fax

(304) 265-6008

NPI assigned

Sep 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396848347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263540399",
            "telephone_number": "304-265-0312",
            "fax_number": "304-265-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N PIKE ST",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263541221",
            "telephone_number": "304-265-4600",
            "fax_number": "304-265-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLES",
        "first_name": "JODY",
        "middle_name": "H.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4001010-000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mistyazia Bolyard
• Sherry L Bolyard
• Haley Nicole Bostic, M.S. CCC-SLP
• Diana Lee Boyle, RN CFNP
• Lora A Boylen
• Alford Bradford
• Tammy Sue Bradford
• Edward P Brennan II, DO
• Andrea Briddle
• Hailee Renee Brown

• General Practice Dentistry in Grafton, WV
• Providers in Grafton, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.