John Phillip Bogue Sr., DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30019869 Issued in OH

Practice address

5950 Airport Highway Suite 10
Toldeo, OH 43615

Phone

(419) 867-9839

Fax

(419) 867-6996

NPI assigned

Dec 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922167139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9165 SOUTH RIVER ROAD",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435669700",
            "telephone_number": "419-878-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 AIRPORT HIGHWAY SUITE 10",
            "city": "TOLDEO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-867-9839",
            "fax_number": "419-867-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUE",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30019869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farhad Sheik Ebrahim, MD
• Yogesh P Patel, MD
• Sunbridge Schools
• Isaac Wang, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Toldeo, OH
• Providers in Toldeo, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.