Amanda Jo Boggs, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.026861 Issued in OH

Practice address

1309 Greene St
Marietta, OH 45750-9172

Phone

(740) 374-0123

NPI assigned

Jun 2, 2022

Sex

Female

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 29, 2023 through Jun 29, 2027

Medicare enrollment (NPD)

Not 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.

• Frye Dental Group LLC

  • Dentist
  • Marietta, OH
  • NPI 1902839996
  NPD (past)

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1831838382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MISSION RD",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457509435",
            "telephone_number": "614-668-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 GREENE ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457509172",
            "telephone_number": "740-374-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Board, NP
• Tilden Dean Bobbitt, D.D.S.
• Susanne Derr Bock, LSW
• Bodies in Motion Chiropractic and Wellness LLC
• Letticia Boehm, CDCA
• Steven M Boker, MD
• Angela S Bolt, LPN
• Mallory Olivia Bonar
• Anna M Bonitatibus
• Gabriel Bookman

• General Practice Dentistry in Marietta, OH
• Providers in Marietta, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.