Individual provider Active NPI

Angela Bova, DDS

  • Dentist
  • Poughkeepsie, NY
National Provider Identifier
1891923389
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
055017 Issued in NY
Practice address
876 Dutchess Tpke
Poughkeepsie, NY 12603-1540
Phone
(845) 454-7023
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 055017 NY Primary

Addresses

Primary practice location

876 Dutchess Tpke
Poughkeepsie, NY 12603-1540

Mailing address

62 Trailhead LN
Tarrytown, NY 10591-5048
Phone (646) 226-3533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20150909002569 NY Order and Referring Only - DentistPractitioner - Dentist 2466769385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055017NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1891923389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 TRAILHEAD LN",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915048",
            "telephone_number": "646-226-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 DUTCHESS TPKE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031540",
            "telephone_number": "845-454-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVA",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.