Active NPI
Dan K. Bolds, D.D.S.
- Endodontics
- South Pasadena, FL
National Provider Identifier
1679990378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN6730
- Practice address
- 6800 Gulfport Blvd S
Suite 201
South Pasadena, FL 33707-2163 - Phone
- (772) 240-2664
- NPI assigned
- Mar 20, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN6730 | FL | Primary |
Addresses
Primary practice location
6800 Gulfport Blvd S
Suite 201
South Pasadena, FL 33707-2163
Mailing address
6800 Gulfport Blvd S
Suite 201
South Pasadena, FL 33707-2163
Phone (772) 240-2664
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395273600000",
"number": "1679990378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 GULFPORT BLVD S",
"address_2": "SUITE 201",
"city": "SOUTH PASADENA",
"state": "FL",
"postal_code": "337072163",
"telephone_number": "772-240-2664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 GULFPORT BLVD S",
"address_2": "SUITE 201",
"city": "SOUTH PASADENA",
"state": "FL",
"postal_code": "337072163",
"telephone_number": "772-240-2664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDS",
"first_name": "DAN",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-20",
"last_updated": "2014-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN6730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.