Michael Gustav Borchardt, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3749 Issued in NC

Practice address

571 Cox Rd
Gastonia, NC 28054-0632

Phone

(704) 865-7603

Fax

(704) 865-6411

NPI assigned

Aug 30, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Gaston Oral & Maxillofacial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Gastonia, NC
  • NPI 1538279757

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639289853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 COX RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540632",
            "telephone_number": "704-865-7603",
            "fax_number": "704-865-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 COX RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540632",
            "telephone_number": "704-865-7603",
            "fax_number": "704-865-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORCHARDT",
        "first_name": "MICHAEL",
        "middle_name": "GUSTAV",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "3749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "90868",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990868",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Jillian Bontkowski, PA-C
• Justin Thomas Booher, PA-C
• Alonzo Galvin Booker, MSW, LCSW-A
• Melissa Artina Booker, LCMHC, LCASA
• Lisa Smith Veale Boone, PA-C
• Lauren Deloach Borders, RDH
• Anthony P Borzotta, MD
• Melanie Blair Boshell, N/A
• Lorraine Bosques Perez
• Dominique Bostic-Arrington, OTR/L

• Oral and Maxillofacial Surgery (Dentist) in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.