Kari Marie Bolen, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D0926 Issued in SD

Practice address

141 N 5TH St
Custer, SD 57730-1528

Phone

(605) 261-6488

NPI assigned

Jun 8, 2009

Last updated

May 6, 2021By 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 SD

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

Locations

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.

• Bolen Dental PC

  dba Custer Dental Studio

  • Dental Clinic/Center
  • Custer, SD
  • NPI 1659962595
  NPD Authorized official
• Bolen Dental PC

  dba Custer Dental Studio

  • Community Health Worker
  • Custer, SD
  • NPI 1770315954
  NPD Authorized official
• Bolen Family Dentistry P.C.

  dba Family Dentistry of Sioux Falls

  • Dental Clinic/Center
  • Sioux Falls, SD
  • NPI 1073819991
  Authorized official Same address or phone
• Sleep Better South Dakota LLC

  • Dentist
  • Custer, SD
  • NPI 1366288292
  NPD
• Glendale Modern Dentistry, LLP

  dba Glendale Modern Dentistry

  • Dentist
  • Glendale, AZ
  • NPI 1255757308
  NPD (past)

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1609002401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N 5TH ST",
            "city": "CUSTER",
            "state": "SD",
            "postal_code": "577301528",
            "telephone_number": "605-261-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N 5TH ST",
            "city": "CUSTER",
            "state": "SD",
            "postal_code": "577301528",
            "telephone_number": "605-261-6488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5143 W Olive Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853024206",
            "country_code": "US",
            "telephone_number": "623-939-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "KARI",
        "middle_name": "MARIE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010608",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08623",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D0926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Lynn Annetts, FNP
• Shellia Marie Bennett, MASSAGE THERAPIST
• Bolen Dental PC (Custer Dental Studio)
• Bolen Dental PC (Custer Dental Studio)
• Kelli Bolton, MA, ATC
• Lisa B Brown, MD
• Laura J. Burden, OTR/L & CMT
• Josephine A. Chase, MSW, LCSW-PIP
• Compassionate Care Hospice of the Hills, LLC

• General Practice Dentistry in Custer, SD
• Providers in Custer, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.