Individual provider Active NPI

Richard Andrew Boehm, D.D.S.

  • Dentist
  • Loudon, TN
National Provider Identifier
1821160045
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9410 Issued in TN
Practice address
16374 Hotchkiss Valley Rd E
Loudon, TN 37774-6064
Phone
(865) 986-3234
Fax
(865) 988-6464
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9410 TN Primary

Addresses

Primary practice location

16374 Hotchkiss Valley Rd E
Loudon, TN 37774-6064

Mailing address

16374 Hotchkiss Valley Rd E
Loudon, TN 37774-6064
Phone (865) 986-3234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20151105000526 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2264742170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Dentures & Implants - Lenoir City III, P.C. CurrentSince Sep 14, 2025 Accepting new patients
Kendall Family Dental Past Accepting new patients
Affordable Dentures & Implants - Lenoir City, P.C. Dentist PastSince Sep 14, 2025 Accepting new patients
Worth Palos Dentistry Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1821160045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16374 HOTCHKISS VALLEY RD E",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377746064",
            "telephone_number": "865-986-3234",
            "fax_number": "865-988-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16374 HOTCHKISS VALLEY RD E",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377746064",
            "telephone_number": "865-986-3234",
            "fax_number": "865-988-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "RICHARD",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudon, TN

Sources for this page

Verify at the official NPI Registry.