Boden Nicholas Slagle, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE61319923 Issued in WA

Practice address

1830 Broadway
Seattle, WA 98122

Phone

(206) 283-9278

NPI assigned

Jul 13, 2022

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

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.

• Sauvage DDS PS

  • Dental Clinic/Center
  • Seattle, WA
  • NPI 1700555612
  NPD (past)

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1629702980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 NE 32ND ST APT A14",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073688",
            "telephone_number": "253-929-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-283-9278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Boren Ave N",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981095505",
            "country_code": "US",
            "telephone_number": "206-364-0231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLAGLE",
        "first_name": "BODEN",
        "middle_name": "NICHOLAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61319923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renata J Slack
• Stephen F Slack, M.D.
• Ian Robert Slade, MD
• Jason Slade
• Megan Christine Slade, LMHC
• David Michael Slagle, PH.D.
• Kimberly Anne Slagle, LMFT
• Heather Slaminski
• Cristina Isabel Slaney, LMHCA
• Adam David Slapin, L.M.P.

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.