Brett D Boden, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

15592 Issued in PA

Practice address

564 W Uwchlan Ave
Exton, PA 19341-1562

Phone

(610) 363-7658

Fax

(610) 524-6839

NPI assigned

May 3, 2007

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

Medicare fee-for-service enrollment

Enrolled in PA

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972725141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 W UWCHLAN AVE",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411562",
            "telephone_number": "610-363-7658",
            "fax_number": "610-524-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 W UWCHLAN AVE",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411562",
            "telephone_number": "610-363-7658",
            "fax_number": "610-524-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODEN",
        "first_name": "BRETT",
        "middle_name": "D",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "15592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Renee Boas, OD
• Mark Brian Boas, OD
• Suzanne O. Boas, OD
• Maria E Bobes
• Brenda Bobko, L.P.C.
• Robert Albert Boden, DDS
• Kelly Boggs, L.AC.
• Michael Bohm
• Robert T Bohnenberger, D.M.D.
• Andrea M Bolesta, PA-C

• Dentist in Exton, PA
• Providers in Exton, PA by specialty
• Dentist in Pennsylvania

• 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.
• 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.