Maxwell A Boatey, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

011072 Issued in CT

Practice address

415 Broad St
Meriden, CT 06450-5839

Phone

(203) 634-1515

Fax

(203) 634-7519

NPI assigned

Jun 6, 2011

Last updated

Sep 6, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409961600000",
    "number": "1720372840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505839",
            "telephone_number": "203-634-1515",
            "fax_number": "203-634-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505839",
            "telephone_number": "203-634-1515",
            "fax_number": "203-634-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATEY",
        "first_name": "MAXWELL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2014-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "011072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latisha Birchett
• Theresa A Blackmer
• Robert L. Block, M.D.
• Blossoming Butterflies LLC
• Bluegrass Medicine & Nephrology, LLC
• Kathleen Bober-Sorcinelli, MD
• Anthony Joseph Boguslawski
• Stephanie M Boguslawski
• Keith C Boldon, M.D.
• Gabriel Patrick Bombino, PA

• General Practice Dentistry in Meriden, CT
• Providers in Meriden, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.