Nicholas Jon Booker, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30-022925 Issued in OH

Practice address

1642 Ralston Circle
Toledo, OH 43615-3801

Phone

(419) 536-7265

Fax

(419) 724-1651

NPI assigned

May 30, 2008

Last updated

May 6, 2010By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1952569584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 RALSTON CIRCLE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436153801",
            "telephone_number": "419-536-7265",
            "fax_number": "419-724-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 RALSTON CIRCLE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436153801",
            "telephone_number": "419-536-7265",
            "fax_number": "419-724-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "NICHOLAS",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-022925",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2872986",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katee E Bons
• Kristen Elizabeth Boog, PHD
• Abigail Booher
• Suzette Michelle Book, R.K.T.
• Justin Booker
• Sonia Booker
• Stephen Booker
• Ellen C Boone, PHD
• Makenzie Marie Boone
• Melissa A Boone

• Dentist in Toledo, OH
• Providers in Toledo, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.