Anna M Budolfson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4007 Issued in ID

Practice address

9203 W Overland Rd
Boise, ID 83709-2502

Phone

(208) 375-1012

Fax

(208) 375-1098

NPI assigned

Dec 19, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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.

• North End Dental PLLC

  • General Practice Dentistry
  • Boise, ID
  • NPI 1902916018
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1841353018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9203 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092502",
            "telephone_number": "208-375-1012",
            "fax_number": "208-375-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9203 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092502",
            "telephone_number": "208-375-1012",
            "fax_number": "208-375-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDOLFSON",
        "first_name": "ANNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6P100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Buckingham
• Michael Lee Buckingham, CRNA
• Penny R Buckland
• Sarah Buckmier
• Briana Rae Budell, LPN
• Dorothy T Buening, MD
• Sarah Buerk
• Darla J. Buffa, APRN
• Hannah Ryan Buffat, RDN, LD
• Jeffrey Buffington, PHARMD

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.