Individual provider Active NPI

James Bodkin, D.M.D.

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1710172986
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12879 Issued in MA
Practice address
1 International PL
Floor 7
Boston, MA 02110-2602
Phone
(617) 330-8887
Fax
(617) 330-8730
NPI assigned
Sep 11, 2007
Last updated
Sep 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12879 MA Primary

Addresses

Primary practice location

1 International PL
Floor 7
Boston, MA 02110-2602

Mailing address

1 International PL
Floor 7
Boston, MA 02110-2602
Phone (617) 330-8887

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

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1710172986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INTERNATIONAL PL",
            "address_2": "FLOOR 7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021102602",
            "telephone_number": "617-330-8887",
            "fax_number": "617-330-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 INTERNATIONAL PL",
            "address_2": "FLOOR 7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021102602",
            "telephone_number": "617-330-8887",
            "fax_number": "617-330-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODKIN",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "12879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.