Bernard Joseph Bouquet, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9524 Issued in MN

Practice address

1008 12TH St SE
Rochester, MN 55904-5030

Phone

(507) 282-6448

NPI assigned

Dec 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective May 24, 2018 through May 24, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 12TH Street Dental Office PA

  • Dentist
  • Rochester, MN
  • NPI 1043374176
  NPD (past)

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437219797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 12TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559045030",
            "telephone_number": "507-282-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 12TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559045030",
            "telephone_number": "507-282-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUQUET",
        "first_name": "BERNARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D9524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy C Boughey, MD
• Corbrielle Nelena Boulard, MD
• Catheryn Bouma, PHARM D
• Chloe Soyoung Bouma
• Emma Caron Bounmixay, APRN, CNP
• Katherine Ann Bouquet, APRN, CRNA, DNAP
• Michelle M Bouquet, PA-C
• Tim Bouquet
• William M Bourne, M.D.
• Sherry Dawn Boutcher, RDH

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, MN by specialty
• General Practice Dentistry in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.