Boonyapa Purt, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D10055 Issued in OR

Practice address

1046 NE 3Rd St
McMinnville, OR 97128-4418

Phone

(503) 472-1468

NPI assigned

Jun 25, 2014

Sex

Female

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

Previously, effective Aug 18, 2022 through Aug 18, 2026

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Mountain View Oral Surgery and Dental Implants

  • Oral and Maxillofacial Surgery (Dentist)
  • McMinnville, OR
  • NPI 1366756389
  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1609281997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 NE 3RD ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 NE 3RD ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284418",
            "telephone_number": "503-472-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURT",
        "first_name": "BOONYAPA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D10055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Pretzer-Krebs
• Alisha Pribble
• Charles Price
• Kayla Joy Price, DACM, LAC
• Julie Pritchett
• Faith Margaret Purvis, DNP, PMHNP, FNP
• Tami Putzier
• Oley Quast, MA, LPC, CADC II
• Gail Quenneville, LCSW
• Radiation Therapy Consultants, PC

• Oral and Maxillofacial Surgery (Dentist) in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.