Active NPI
Albert Boholst, DMD, PA
- General Practice Dentistry
- Wesley Chapel, FL
National Provider Identifier
1679590004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13536
- Practice address
- 27510 Cashford Cir
Wesley Chapel, FL 33544-6910 - Phone
- (813) 973-8555
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13536 | FL | Primary |
Addresses
Primary practice location
27510 Cashford Cir
Wesley Chapel, FL 33544-6910
Mailing address
27510 Cashford Cir
Wesley Chapel, FL 33544-6910
Phone (813) 973-8555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13536 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287446400000",
"number": "1679590004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27510 CASHFORD CIR",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335446910",
"telephone_number": "813-973-8555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27510 CASHFORD CIR",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335446910",
"telephone_number": "813-973-8555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHOLST",
"first_name": "ALBERT",
"credential": "DMD, PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2010-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "13536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.