John Edwin Boland III, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22784 Issued in CA

Practice address

770 Tamalpais Dr
Suite 404
Corte Madera, CA 94925-1700

Phone

(415) 927-7711

NPI assigned

Aug 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992717284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 TAMALPAIS DR",
            "address_2": "SUITE 404",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251700",
            "telephone_number": "415-927-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 TAMALPAIS DR",
            "address_2": "SUITE 404",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251700",
            "telephone_number": "415-927-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "JOHN",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "22784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Berman, PSY 15396
• Emily Jo Bernard, AUD
• Anne K Bjork
• Martin Block, PH.D.
• John Edwin Boland IV, D.D.S.
• Darby Furth Bonomi, PH.D.
• Steven S Bordunov, DC
• Edwin B. Bottum-Morgan, PH.D.
• Marion Katherine Brennan, LCSW
• Brett V. Curtis, M.D. Inc. Apc (Medical Center of Marin)

• Pediatric Dentistry in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Pediatric Dentistry in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.