Active NPI
Bolen Dental PC
Doing business as Custer Dental Studio
- Dental Clinic/Center
- Custer, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- BOLEN DENTAL PC
- Doing business as
- Custer Dental Studio
- Practice address
- 141 N 5TH St
Custer, SD 57730-1528 - Phone
- (605) 321-2086
- NPI assigned
- Feb 2, 2021
- Last updated
- May 6, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kari Bolen, DDS
- Title
- President Bolen Dental PC
- Phone
- (605) 261-6488
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | NU | Primary |
Addresses
Primary practice location
141 N 5TH St
Custer, SD 57730-1528
Mailing address
141 N 5TH St
Custer, SD 57730-1528
Phone (605) 261-6488
Other names 1
- Custer Dental Studio
National Provider Directory
National Provider Directory- Tax ID family
- Bolen Dental PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
141 N 5th St
Custer, SD 57730
Phone (605) 673-2011
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Custer, SD
- NPI 1609002401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620259200000",
"number": "1659962595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 N 5TH ST",
"city": "CUSTER",
"state": "SD",
"postal_code": "577301528",
"telephone_number": "605-261-6488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 N 5TH ST",
"city": "CUSTER",
"state": "SD",
"postal_code": "577301528",
"telephone_number": "605-321-2086"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOLEN DENTAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-02",
"last_updated": "2021-05-06",
"certification_date": "2021-05-06",
"status": "A",
"authorized_official_last_name": "BOLEN",
"authorized_official_first_name": "KARI",
"authorized_official_title_or_position": "PRESIDENT BOLEN DENTAL PC",
"authorized_official_telephone_number": "605-261-6488",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Custer Dental Studio",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Custer Dental Studio",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Custer, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.