Individual provider Active NPI

Julia R Kinlaw, DDS

  • General Practice Dentistry
  • Wyoming, OH
National Provider Identifier
1962584300
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30015917 Issued in OH
Practice address
411 Wyoming Ave
Wyoming, OH 45215
Phone
(513) 821-0659
Fax
(513) 821-0656
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30015917 OH Primary

Addresses

Primary practice location

411 Wyoming Ave
Wyoming, OH 45215

Mailing address

411 Wyoming Ave
Wyoming, OH 45215
Phone (513) 821-0659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150623000608 OH Order and Referring Only - DentistPractitioner - Dentist 0244541969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30015917OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Emily a. Boehm DDS, LLC General Practice PastSince Dec 22, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962584300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WYOMING AVE",
            "city": "WYOMING",
            "state": "OH",
            "postal_code": "45215",
            "telephone_number": "513-821-0659",
            "fax_number": "513-821-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WYOMING AVE",
            "city": "WYOMING",
            "state": "OH",
            "postal_code": "45215",
            "telephone_number": "513-821-0659",
            "fax_number": "513-821-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINLAW",
        "first_name": "JULIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30015917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, OH

Sources for this page

Verify at the official NPI Registry.