Audra Alexandra Boehm

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

MD61663011 Issued in WA

Practice address

8745 Pacific Ave NW # 102
Silverdale, WA 98383-8394

Phone

(602) 045-1223

NPI assigned

Feb 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Oral Surgery

Education

Columbia University College of Dental Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Tracy R. Johnson, DDS, PS

  • Oral and Maxillofacial Surgery (Dentist)
  • Port Orchard, WA
  • NPI 1376718957
  Medicare reassignment

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1811452303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8745 PACIFIC AVE NW # 102",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838394",
            "telephone_number": "602-045-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 PACIFIC AVE NW # 102",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838394",
            "telephone_number": "602-045-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "AUDRA",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE61663002",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "MD61663011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianne Blocher
• Blue Horizon Medical Alternatives
• Blue Wave Eye Doctors Professional Limited Liability Company (Visionworks Doctors of Optometry)
• Ashley Nicole Blue, M.S. SLP-CCC
• Teresa Boad Brooks, M.A.
• Isabella Rane Bogen
• Nancy J Bohannon, M.D.
• Gwendelyn Grace Boisen
• Richard E Bolton, IDC
• Janet McPherson Boltwood, LICSW

• Oral and Maxillofacial Surgery (Dentist) in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.