NPIMap

Organization Active NPI

Bruce a Boretsky DMD, LLC

  • Periodontics
  • Columbus, GA
National Provider Identifier
1962614610
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN012109 Issued in GA
Legal business name
BRUCE A BORETSKY DMD, LLC
Practice address
7310 N Lake Dr
Suite C
Columbus, GA 31909-2787
Phone
(706) 653-2600
Fax
(706) 494-1000
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Dr. Bruce A Boretsky, DMDNPI 1689916504
Title
Periodontist
Phone
(706) 653-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DN012109 GA Primary

Addresses

Primary practice location

7310 N Lake Dr
Suite C
Columbus, GA 31909-2787

Mailing address

7310 N Lake Dr
Suite C
Columbus, GA 31909-2787
Phone (706) 653-2600

National Provider Directory

National Provider Directory

Locations

7310 North Lake Dr
Ste C
Columbus, GA 31909
Phone (706) 222-7799

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1962614610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 N LAKE DR",
            "address_2": "SUITE C",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092787",
            "telephone_number": "706-653-2600",
            "fax_number": "706-494-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 N LAKE DR",
            "address_2": "SUITE C",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092787",
            "telephone_number": "706-653-2600",
            "fax_number": "706-494-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE A BORETSKY DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "BORETSKY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "706-653-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DN012109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.