Scott Brian Boltz, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008297A Issued in IN

Practice address

604 E Boulevard St.
Suite B
Kokomo, IN 46902-2286

Phone

(765) 864-2328

Fax

(765) 864-2333

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Compassionate Dentistry, P.C.

  • Dental Clinic/Center
  • Kokomo, IN
  • NPI 1063658631
  NPD (past) Authorized official

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231200000000",
    "number": "1821178609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 N 850 EAST",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469368828",
            "telephone_number": "765-628-3204",
            "fax_number": "765-864-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E BOULEVARD ST.",
            "address_2": "SUITE B",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022286",
            "telephone_number": "765-864-2328",
            "fax_number": "765-864-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTZ",
        "first_name": "SCOTT",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008297A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Boggs
• Lythun Boggs
• Victoria C Bogue
• Paul Bojrab, MD
• Addison Boles, RBT
• Bona Vista Programs, Inc.
• Bona Vista Programs, Inc.
• Bona Vista Programs, Inc.
• Bona Vista Programs, Inc.
• Bona Vista Programs, Inc.

• General Practice Dentistry in Kokomo, IN
• Providers in Kokomo, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.