NPIMap

Organization Active NPI

Ma Boule DMD PC

Doing business as Boule Dental

  • General Practice Dentistry
  • Plano, IL
National Provider Identifier
1700043064
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026313 Issued in IL
Legal business name
MA BOULE DMD PC
Doing business as
Boule Dental
Practice address
3910 Turner Ave
Plano, IL 60545-9727
Phone
(630) 552-3410
Fax
(630) 552-1543
NPI assigned
May 22, 2008
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Dr. Melvin Anthony Boule, DMDNPI 1730211764
Title
Owner
Phone
(630) 552-3410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019026313 IL Primary

Addresses

Primary practice location

3910 Turner Ave
Plano, IL 60545-9727

Mailing address

3910 Turner Ave
Plano, IL 60545-9727
Phone (630) 552-3410

Other names 1

  • Boule Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3910 Turner Ave
Plano, IL 60545
Phone (630) 552-3410

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1700043064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 TURNER AVE",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605459727",
            "telephone_number": "630-552-3410",
            "fax_number": "630-552-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 TURNER AVE",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605459727",
            "telephone_number": "630-552-3410",
            "fax_number": "630-552-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MA BOULE DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "BOULE",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-552-3410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boule Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.