Richard C Bolten DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901012575 Issued in MI

Legal business name

RICHARD C BOLTEN DDS PC

Practice address

4721 Dixie Hwy
Waterford, MI 48329-3565

Phone

(248) 673-7026

Fax

(248) 673-6989

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard Carl Bolten, DDS

Title

President

Phone

(248) 673-7026

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427185776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293565",
            "telephone_number": "248-673-7026",
            "fax_number": "248-673-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293565",
            "telephone_number": "248-673-7026",
            "fax_number": "248-673-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD C BOLTEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLTEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-673-7026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901012575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "2901012575",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Waterford, MI
• Providers in Waterford, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.