Beau Bolding, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11954 Issued in TN

Practice address

1300 Hatcher LN Ste 1
Columbia, TN 38401-3554

Phone

(931) 388-2279

Fax

(931) 223-5567

NPI assigned

Mar 9, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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 and National Provider Directory roles.

• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1669474425
  Medicare reassignment NPD
• Robert C Wilhite Jr DDS PLLC

  • Dental Clinic/Center
  • Columbia, TN
  • NPI 1497307730
  NPD
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Baxter Springs, KS
  • NPI 1487351086
  NPD

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1659028652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HATCHER LN STE 1",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013554",
            "telephone_number": "931-388-2279",
            "fax_number": "931-223-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HATCHER LN STE 1",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013554",
            "telephone_number": "931-388-2279",
            "fax_number": "931-223-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDING",
        "first_name": "BEAU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-09",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "62214",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "4294-22",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Shawn Blocker, MSN, APRN, NP-C
• Ronald Blocker
• Tamatha Ann Bobo, CRNA
• Krista Boesing
• Sara Boggs, OTR/L
• Christie Lynn Bolton, BS
• Raymond Carlton Bolton, REGISTERED NURSE
• Deanna Michelle Bommarito
• Lindsey Hawthorne Bonas-Page
• Samuel Booker

• General Practice Dentistry in Columbia, TN
• Providers in Columbia, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.