Dr Anna M Bolanis Family Dentistry Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1151 Issued in VT

Legal business name

DR ANNA M BOLANIS FAMILY DENTISTRY INC

Practice address

760 West Lakeshore Dr
Suite 1
Colchester, VT 05446-1580

Phone

(802) 862-9282

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Anna M Bolanis, DDSNPI 1164571402

Title

Owner Dentist

Phone

(802) 862-9282

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna M Bolanis, DDS

  • General Practice Dentistry
  • Colchester, VT
  • NPI 1164571402

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1740469345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WEST LAKESHORE DR",
            "address_2": "SUITE 1",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054461580",
            "telephone_number": "802-862-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WEST LAKESHORE DR",
            "address_2": "SUITE 1",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054461580",
            "telephone_number": "802-862-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ANNA M BOLANIS FAMILY DENTISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "BOLANIS",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "802-862-9282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "1151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003605",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Loveday Greene Dewolfe, BS OTR
• Kayla June Disciullo, PTA
• Sarah Doben, PT, DPT
• Jillian Leigh Donovan, PHARMD
• Priscilla Douglas, M.S.
• Dr. Kenneth Palm
• Thomas Peter Drougas, RPH
• Owen W Drudge, PH.D.
• Megan Dunston, LCMHC
• John M Dupont, COTA

• All providers in Colchester, VT
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.