Active NPI
Alan Graham Boggie, D.M.D.
- General Practice Dentistry
- Spartanburg, SC
National Provider Identifier
1528016367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3688
- Practice address
- 371 Whitney Rd
Spartanburg, SC 29303-3143 - Phone
- (864) 515-0485
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 3688 | SC | Primary |
Addresses
Primary practice location
371 Whitney Rd
Spartanburg, SC 29303-3143
Mailing address
415 N Grand Ave
Pueblo, CO 81003-3111
Phone (719) 546-3333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZX3688 | Medicaid | SC |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3688 | SC | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1528016367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 N GRAND AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033111",
"telephone_number": "719-546-3333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "371 WHITNEY RD",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293033143",
"telephone_number": "864-515-0485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGGIE",
"first_name": "ALAN",
"middle_name": "GRAHAM",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "3688",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZX3688",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.