Mid-Missouri Institute of Dental Sleep Medicine LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MID-MISSOURI INSTITUTE OF DENTAL SLEEP MEDICINE LLC

Practice address

1505 Chapel Hill Rd
Suite 203
Columbia, MO 65203-5506

Phone

(573) 303-5501

NPI assigned

Jul 21, 2014

Organization subpart

No

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

Authorized official

Name

Richard S Bohon, DDSNPI 1669540985

Title

Owner/DDS

Phone

(309) 282-8565

Specialties & licenses 1

Addresses

Other names 1

• Bohon Sleep and TMJ Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Richard Stanley Bohon, DDS

  • General Practice Dentistry
  • Columbia, MO
  • NPI 1669540985
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647820800000",
    "number": "1871900977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 CHAPEL HILL RD",
            "address_2": "SUITE 203",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 CHAPEL HILL RD",
            "address_2": "SUITE 203",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035506",
            "telephone_number": "573-303-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MISSOURI INSTITUTE OF DENTAL SLEEP MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "BOHON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "309-282-8565",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bohon Sleep and TMJ Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Columbia, MO
• Providers in Columbia, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.