Boonsboro Dental Care, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10096 Issued in MD

Legal business name

BOONSBORO DENTAL CARE, LLC

Doing business as

South Mountain Dental

Practice address

708 Chase Six Blvd
Boonsboro, MD 21713-2059

Phone

(301) 432-4322

Fax

(300) 432-4330

NPI assigned

Apr 9, 2015

Last updated

Apr 9, 2015By 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

Kenneth Film, DDSNPI 1881698223

Title

Managing Member

Phone

(301) 432-4322

Specialties & licenses 1

Addresses

Other names 1

• South Mountain Dental Doing business as

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.

• Kenneth Anson Film, DDS

  • General Practice Dentistry
  • Boonsboro, MD
  • NPI 1881698223
  NPD (past) Authorized official

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1780070482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CHASE SIX BLVD",
            "city": "BOONSBORO",
            "state": "MD",
            "postal_code": "217132059",
            "telephone_number": "301-432-4322",
            "fax_number": "300-432-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHASE SIX BLVD",
            "city": "BOONSBORO",
            "state": "MD",
            "postal_code": "217132059",
            "telephone_number": "301-432-4322",
            "fax_number": "300-432-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONSBORO DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "FILM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "301-432-4322",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "10096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Mountain Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Franklin Bodenheimer III, M.D.
• Bodysense PT, LLC
• George Bolger, RPH
• Sharon Bolger, RPH
• Boonsboro Ambulance and Rescue Service Incorporated
• Boonsboro Wellness Center, Inc.
• Jessica Nichole Brangaccio, LCSW-C
• Brinton Woods of Boonsboro, LLC
• Brinton Woods of Boonsboro, LLC
• Kristen Byers

• General Practice Dentistry in Boonsboro, MD
• Providers in Boonsboro, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.