Tara Brooke Boshnack, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6271 Issued in NV

Practice address

4955 S Durango Dr
201
Las Vegas, NV 89113

Phone

(702) 933-7275

NPI assigned

Oct 11, 2012

Last updated

Oct 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

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.

• P3 Dental - Welebir PC

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1063980142
  NPD (past)
• P3 Dental - Welebir PC

  • General Practice Dentistry
  • North Las Vegas, NV
  • NPI 1407325129
  NPD (past)

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1437401619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2866 LOVELAND DR",
            "address_2": "UNIT 2036",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891090227",
            "telephone_number": "516-509-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S DURANGO DR",
            "address_2": "201",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89113",
            "telephone_number": "702-933-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSHNACK",
        "first_name": "TARA",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6271",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19585",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056092",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Boschee, LCSW
• Sharise Bose
• Stephanie Boseck
• Avery Joseph Boser, RBT
• Workenish Boset
• Michelle Cody Bosinger-Shannon
• Michael Boske
• Kristi Boskovich
• Katrina Bosley
• Paul Bosley

• Dentist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.