NPIMap

Organization Active NPI

Boles and Ham DDS PA

  • General Practice Dentistry
  • Wilson, NC
National Provider Identifier
1679546774
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BOLES AND HAM DDS PA
Practice address
109 Brentwood Center Lane N
Wilson, NC 27896
Phone
(252) 291-2892
Fax
(252) 399-7624
NPI assigned
Feb 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Susan P Powell
Title
Office Manager
Phone
(252) 291-2892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X NC Primary

Addresses

Primary practice location

109 Brentwood Center Lane N
Wilson, NC 27896

Mailing address

109 Brentwood Center Lane N
Wilson, NC 27896
Phone (252) 291-2892

National Provider Directory

National Provider Directory

Locations

109 Brentwood Center Ln N
Wilson, NC 27896
Phone (252) 291-2892

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679546774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BRENTWOOD CENTER LANE N",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27896",
            "telephone_number": "252-291-2892",
            "fax_number": "252-399-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BRENTWOOD CENTER LANE N",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27896",
            "telephone_number": "252-291-2892",
            "fax_number": "252-399-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLES AND HAM DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-291-2892",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.