Bokang Bogopane, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DD4525 Issued in NM

Practice address

9401 Coors Blvd NW
Albuquerque, NM 87114-4007

Phone

(505) 890-2773

Fax

(505) 898-3022

NPI assigned

Jun 21, 2016

Last updated

Feb 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1720438716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144007",
            "telephone_number": "505-890-2773",
            "fax_number": "505-898-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144007",
            "telephone_number": "505-890-2773",
            "fax_number": "505-898-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOPANE",
        "first_name": "BOKANG",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4525",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynda Bogar
• Jennifer Bogart
• Michael Bogenschutz, MD
• David Breck Boggio, SW
• Maria Boggio, PT
• Devin L Bogus, MD
• Leah Bogusch, PHD
• Juliane Nichole Bohan, MD
• Sarah Boissiere, FNP-BC
• Mariana Boitano, L.P.N

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.