Gregory Charles Bohle, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

055610 Issued in NY

Practice address

1 Mark Tree Rd
Centereach, NY 11720-2279

Phone

(631) 737-2626

Fax

(631) 673-6299

NPI assigned

Apr 24, 2009

Last updated

May 15, 2023By 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 Apr 19, 2023 through Apr 19, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Asnis Dental, PLLC

  • Dentist
  • Lynbrook, NY
  • NPI 1437623378
  NPD (past)

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1538303243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MARK TREE RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202279",
            "telephone_number": "631-737-2626",
            "fax_number": "631-673-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARK TREE RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202279",
            "telephone_number": "631-737-2626",
            "fax_number": "631-673-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLE",
        "first_name": "GREGORY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-24",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "055610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Jennifer Berkowitz, RN
• Melanie Ann Bernocco, PT, DPT
• Dolores Isabel Binstock, LSP
• Valentina Blaine, O.D.
• Joseph William Boccio, LPN
• Christa Rebecca Bordeaux, PHARM.D.
• Gianna Boscarino
• Gina Marie Bosco
• Melissa T. Bossert, MS CCC SLP
• Victoria Bossoreale, PT

• Oral and Maxillofacial Surgery (Dentist) in Centereach, NY
• Providers in Centereach, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.