Boston Dental of Wi LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BOSTON DENTAL OF WI LLC

Practice address

3064 S Business Dr
Sheboygan, WI 53081-6522

Phone

(920) 892-6961

NPI assigned

Dec 6, 2017

Last updated

Dec 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Boston

Title

Owner

Phone

(920) 892-6961

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Calen H Leider, D.D.S.

  • Dentist
  • Sheboygan, WI
  • NPI 1508203076
  NPD (past)

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1730694225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3064 S BUSINESS DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816522",
            "telephone_number": "920-892-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON DENTAL OF WI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "BOSTON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-892-6961"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary G Boll, RD
• Leah M. Bonde-Langenfeld, MA
• Karen M Bonner, N.P.
• Kathleen Borndahl
• Grant G Boschult, MD
• Robert Bouche
• Christopher Scott Bowers, MA
• Teresa Boxrucker
• Bridget C Boy, PTA
• Julia Brainard, DMD

• General Practice Dentistry in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.