Herbert Reed Boyd III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005626 Issued in VA

Practice address

23 Goodrich Ave
Petersburg, VA 23805-2119

Phone

(804) 861-5237

Fax

(804) 861-1601

NPI assigned

Aug 30, 2006

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

Other identifiers 3

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 and National Provider Directory roles.

• Petersburg Complete Dental Care PLLC

  • General Practice Dentistry
  • Petersburg, VA
  • NPI 1770824435
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1942319264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 GOODRICH AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052119",
            "telephone_number": "804-861-5237",
            "fax_number": "804-861-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 GOODRICH AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052119",
            "telephone_number": "804-861-5237",
            "fax_number": "804-861-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "HERBERT",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "844394",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179969",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF VA.",
            "identifier": "006397",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bon Secours Mercy Health Petersburg LLC (Bon Secours - Southside Medical Center)
• Bon Secours St. Francis Medical Center, Inc. (Bon Secours Freedom Healthcare Associates)
• Sharon Booker
• Bowers Hearing Care Professionals Inc
• Richard C Bowers Jr., PHD
• Felicia Sherry Bracey
• Jacelyn Taylor Bradford, PHARM D
• Lynette Galloway Branch, R.N., N. P/
• Bread of Life Solutions LLC (Bread of Life Residential Services)
• Breakthrough Behavioral Health LLC

• General Practice Dentistry in Petersburg, VA
• Providers in Petersburg, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.