Ronald Charles O'Boyle, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS018292L Issued in PA

Practice address

4 Fork St
Suite 3040
Mount Pocono, PA 18344-1200

Phone

(570) 839-8065

Fax

(570) 839-8649

NPI assigned

Jul 27, 2006

Last updated

Jul 8, 2007By 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

Enrolled in PA

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

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871517045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FORK ST",
            "address_2": "SUITE 3040",
            "city": "MOUNT POCONO",
            "state": "PA",
            "postal_code": "183441200",
            "telephone_number": "570-839-8065",
            "fax_number": "570-839-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FORK ST",
            "address_2": "SUITE 3040",
            "city": "MOUNT POCONO",
            "state": "PA",
            "postal_code": "183441200",
            "telephone_number": "570-839-8065",
            "fax_number": "570-839-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BOYLE",
        "first_name": "RONALD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS018292L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Mount Pocono, PA
• Providers in Mount Pocono, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.