Russell B Boyter, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

005230 Issued in TN

Practice address

1630 NW Broad St
Suite 101
Murfreesboro, TN 37129

Phone

(615) 896-0608

Fax

(615) 848-9444

NPI assigned

Aug 29, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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.

• TW New Dentistry, PLLC

  dba Stones River Dental

  • Dental Clinic/Center
  • Murfreesboro, TN
  • NPI 1164134599
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497864193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 NW BROAD ST",
            "address_2": "SUITE 101",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37129",
            "telephone_number": "615-896-0608",
            "fax_number": "615-848-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 NW BROAD ST",
            "address_2": "SUITE 101",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37129",
            "telephone_number": "615-896-0608",
            "fax_number": "615-848-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYTER",
        "first_name": "RUSSELL",
        "middle_name": "B",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "005230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "4033615",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janna Boydstun
• Ashley Brooke Boyer, PMH-NP-BC
• Dawn Vyrelle Boyer, MSN, PMHNP-BC
• Teresa Boyer, APN-BC
• Kathy Boykin
• Jennifer Easterling Brabson, RPH, PHARMD, BCPP
• Alyssa Bradbury
• Jonathan Braden
• Elizabeth Hope Bradley X
• Julie Bradley, LADAC II, NCAC II

• Dentist in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Dentist in Tennessee

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.