Individual provider Active NPI

Lee Boney, DMD

  • Dentist
  • Thomasville, GA
National Provider Identifier
1689836033
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014145 Issued in GA
Practice address
215 Constitution Dr
Thomasville, GA 31757-4901
Phone
(229) 226-2386
Fax
(229) 226-9838
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN18357 FL
Dentist 122300000X DN014145 GA Primary

Addresses

Primary practice location

215 Constitution Dr
Thomasville, GA 31757-4901

Mailing address

215 Constitution Dr
Thomasville, GA 31757-4901
Phone (229) 226-2386

Other identifiers 1

IdentifierTypeStateIssuer
856534042AMedicaidGA

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

State licenses

LicenseStateTypeSpecialty
DN18357FLMDDentist
DN014145GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomasville Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1689836033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CONSTITUTION DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574901",
            "telephone_number": "229-226-2386",
            "fax_number": "229-226-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CONSTITUTION DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574901",
            "telephone_number": "229-226-2386",
            "fax_number": "229-226-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONEY",
        "first_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18357",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856534042A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.