Blaine Travis Bohrer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410722 Issued in VA

Legal business name

BLAINE TRAVIS BOHRER, DDS

Practice address

1577 General Booth Blvd
#107
Virginia Beach, VA 23454-5105

Phone

(757) 428-8282

Fax

(757) 437-0415

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Blaine Travis Bohrer, DDSNPI 1285779827

Title

Dentist

Phone

(757) 428-8282

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blaine Travis Bohrer, DDS

  • General Practice Dentistry
  • Virginia Beach, VA
  • NPI 1285779827

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1861674699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 GENERAL BOOTH BLVD",
            "address_2": "#107",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545105",
            "telephone_number": "757-428-8282",
            "fax_number": "757-437-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 GENERAL BOOTH BLVD",
            "address_2": "#107",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545105",
            "telephone_number": "757-428-8282",
            "fax_number": "757-437-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAINE TRAVIS BOHRER, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "BOHRER",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_middle_name": "TRAVIS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "757-428-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Blackwell, CCC-SLP
• Whitney N Blackwell
• George Vaden Blackwood, D.O.
• Robert Charles Blackwood, MD
• Zylina Blain
• Jillian Blaine
• Alysia Blais
• Marina Yevgenyevna Blajkevich, M.D.
• Kailey Blakeney
• Blanchard Dentistry, LLC

• General Practice Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.