Jonathan Keith Bookout, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN015004 Issued in GA

Practice address

444 N Belair Rd Ste 101
Evans, GA 30809-3002

Phone

(762) 218-2186

Fax

(762) 200-2302

NPI assigned

Jun 29, 2015

Last updated

Mar 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Legacy Dental Group, LLC

  • General Practice Dentistry
  • Evans, GA
  • NPI 1578330197
  NPD Authorized official
• Georgia Dental Associates LLC

  • General Practice Dentistry
  • Cordele, GA
  • NPI 1346919537
  NPD (past)

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1861874638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4847 HIGH MEADOWS DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308138103",
            "telephone_number": "912-389-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N BELAIR RD STE 101",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093002",
            "telephone_number": "762-218-2186",
            "fax_number": "762-200-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKOUT",
        "first_name": "JONATHAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Carol Boggs, CCC-SLP
• Victoria C Boling, DPT
• Nicole Bomarito
• Gena Marie Bonitatibus, M.D.
• Bonro Medical Inc
• Anne Margaret Booz
• Charles Lawson Bost, LPC
• Lori Marie Boswell, CRNA
• Susan Boswell, LMSW
• Siham Bouchannout, RD

• Dentist in Evans, GA
• Providers in Evans, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.