Active NPI
Richard Carl Bolten, DDS
- General Practice Dentistry
- Waterford, MI
National Provider Identifier
1457323313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901012575
- Practice address
- 4721 Dixie Hwy
Waterford, MI 48329-3522 - Phone
- (248) 673-7026
- Fax
- (248) 673-6989
- NPI assigned
- Feb 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901012575 | MI | Primary |
Addresses
Primary practice location
4721 Dixie Hwy
Waterford, MI 48329-3522
Mailing address
4721 Dixie Hwy
Waterford, MI 48329-3522
Phone (248) 673-7026
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901012575 | Other | MI | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901012575 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1457323313",
"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": "483293522",
"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": "483293522",
"telephone_number": "248-673-7026",
"fax_number": "248-673-6989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTEN",
"first_name": "RICHARD",
"middle_name": "CARL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901012575",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "2901012575",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.