Individual provider Active NPI

Allison Bockrath

  • General Practice Dentistry
  • Waynesville, OH
National Provider Identifier
1609442540
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.026442 Issued in OH
Practice address
4353 E State Route 73
Waynesville, OH 45068-8812
Phone
(513) 897-0248
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10586 KY
General Practice Dentistry 1223G0001X 30.026442 OH Primary

Addresses

Primary practice location

4353 E State Route 73
Waynesville, OH 45068-8812

Mailing address

3811 Grand Oak TRL
Dayton, OH 45440-5011
Phone (937) 776-5019

Other practice location 1

1335 Hansel Ave
Florence, KY 41042-4803
Phone (859) 647-7068

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

LicenseStateTypeSpecialty
10586KYMDGeneral Practice Dentistry
30.026442OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1609442540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 GRAND OAK TRL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454405011",
            "telephone_number": "937-776-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 E STATE ROUTE 73",
            "city": "WAYNESVILLE",
            "state": "OH",
            "postal_code": "450688812",
            "telephone_number": "513-897-0248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1335 Hansel Ave",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410424803",
            "country_code": "US",
            "telephone_number": "859-647-7068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOCKRATH",
        "first_name": "ALLISON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10586",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.