Individual provider Active NPI

Richard S Bohnstedt, DMD

  • Dentist
  • Deming, NM
National Provider Identifier
1679903355
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4020 Issued in NM
Practice address
125 Chaparrel Blvd NW
Deming, NM 88030-8629
Phone
(575) 546-4800
Fax
(575) 546-5048
NPI assigned
Nov 18, 2013
Last updated
Nov 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD4020 NM Primary

Addresses

Primary practice location

125 Chaparrel Blvd NW
Deming, NM 88030-8629

Mailing address

PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20150528001038 NM Order and Referring Only - DentistPractitioner - Dentist 3173843455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD4020NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ben Archer Health Center Past Accepting new patients
Ben Archer Health Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1679903355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHAPARREL BLVD NW",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880308629",
            "telephone_number": "575-546-4800",
            "fax_number": "575-546-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHNSTEDT",
        "first_name": "RICHARD",
        "middle_name": "S",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deming, NM

Sources for this page

Verify at the official NPI Registry.