David Boules, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN20722 Issued in FL

Practice address

123 W Plymouth Ave
Deland, FL 32720-2721

Phone

(386) 736-8865

Fax

(386) 736-6890

NPI assigned

May 20, 2014

Sex

Male

Sole proprietor

Yes

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dale D Batten, DMD

  • Dental Clinic/Center
  • Deland, FL
  • NPI 1962290676
  NPD
• Avalon Dental, LLC

  • Dental Clinic/Center
  • Deland, FL
  • NPI 1346677200
  NPD (past)

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1750792180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 NEW BOLTON DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321295327",
            "telephone_number": "386-405-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202721",
            "telephone_number": "386-736-8865",
            "fax_number": "386-736-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULES",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew R Blum, M.D.
• Noelani Blye
• Sheryl A Booher, AUD
• Latisha Y Bordley
• Graham Borysko, D.O.
• Jarrett Bourque, DC
• Krystal Boza, MSW
• Jaime Roberto Bracero, PHARMD
• Ivan L Bradley, RPH
• Michelle Bradt, LCSW

• Dentist in Deland, FL
• Providers in Deland, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.