Individual provider Active NPI

Robert John Boyda Sr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Pittsburgh, PA
National Provider Identifier
1811174774
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS017371 Issued in PA
Practice address
1910 Cochran Rd
Pittsburgh, PA 15220-1203
Phone
(412) 343-7855
Fax
(412) 343-7856
NPI assigned
Jan 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS017371 PA Primary

Addresses

Primary practice location

1910 Cochran Rd
Pittsburgh, PA 15220-1203

Mailing address

989 Osage Rd
Pittsburgh, PA 15243-1049
Phone (412) 279-7328

Other identifiers 1

IdentifierTypeStateIssuer
0535890MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS017371PAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1811174774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 OSAGE RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431049",
            "telephone_number": "412-279-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 COCHRAN RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152201203",
            "telephone_number": "412-343-7855",
            "fax_number": "412-343-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYDA",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS017371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0535890",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.