Kent T Botsford III

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1223G0001X Issued in WI

Practice address

525 East Division Street
Fond Du Lac, WI 54935

Phone

(920) 921-2860

Fax

(920) 921-4228

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417041005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 EAST DIVISON STREET",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "54935",
            "telephone_number": "920-921-2860",
            "fax_number": "920-921-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 EAST DIVISION STREET",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "54935",
            "telephone_number": "920-921-2860",
            "fax_number": "920-921-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTSFORD",
        "first_name": "KENT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1223G0001X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Borowitz, P.T. AND O.T.
• David Borsky, DDS, MSD
• Kathryn S. Borsodi, M.D.
• Jessica L Bosquez, DPT
• Lindsy Bothe, PTA
• Tammy Marie Boudry, DDS
• David R Bowman, M.D.
• Sally Bowman
• Andrea Rose Boyce
• Margaret Miller Boyd, ACUPUNCTURIST

• General Practice Dentistry in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.