J.C. Boley, D.D.S., M.S., Inc.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

7425 Issued in TX

Legal business name

J.C. BOLEY, D.D.S., M.S., INC.

Practice address

400 S Cottonwood Dr
Richardson, TX 75080-5708

Phone

(972) 231-4896

Fax

(972) 994-9747

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Jimmy Carroll Boley, D.D.S., M.S.

Title

President

Phone

(972) 231-4896

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760501944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S COTTONWOOD DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805708",
            "telephone_number": "972-231-4896",
            "fax_number": "972-994-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S COTTONWOOD DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805708",
            "telephone_number": "972-231-4896",
            "fax_number": "972-994-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.C. BOLEY, D.D.S., M.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLEY",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "CARROLL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-231-4896",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "7425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSINSURANCE PROVIDER #",
            "identifier": "00C652",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Richardson, TX
• Providers in Richardson, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.