BOLEN FAMILY DENTISTRY P.C. (NPI# 1073819991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073819991 |
| Entity Type | Organization |
| Organization Name | BOLEN FAMILY DENTISTRY P.C. |
| Other Organization Name | FAMILY DENTISTRY OF SIOUX FALLS |
| Practice Address |
3508 S Minnesota Ave Ste 108 Sioux Falls SD 57105-6455 |
| Practice Telephone | 6053390219 |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2011-02-10 |
| Authorized Official Name | KARI M BOLEN (DIRECTOR/PRESIDENT) |
| Authorized Official Telephone | 6052616488 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D0926 | SD | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Dentistry of Sioux Falls | Doing Business As Name - Organization |
| Street Address |
3508 S MINNESOTA AVE STE 108 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-6455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255752291 | Katie Reardon Dds, PC | Dentist | 3508 S Minnesota Ave Ste 108, Sioux Falls, SD 57105-6455 | 2013-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114329265 | Josh Brower Dds Prof LLC | Clinic/Center | 5000 W Empire Mall, Empire Mall Suite 924, Sioux Falls, SD 57106-6523 | 2014-09-19 |
| 1447291174 | General Dentistry, Ltd. | Clinic/Center | 3508 S Minnesota Ave, Suite #108, Sioux Falls, SD 57105-6461 | 2006-06-10 |
| 1083215487 | Wermerson Orthodontics Prof LLC | Clinic/Center | 5200 S Cliff Ave Ste 102, Sioux Falls, SD 57108-5400 | 2020-11-03 |
| 1346849411 | Rachel C Soyland Dds PC | Clinic/Center | 1721 S Cleveland Ave Ste 100, Sioux Falls, SD 57103-5502 | 2020-10-20 |
| 1447857982 | Van Hofwegen Dental | Clinic/Center | 5120 S Cliff Ave, Sioux Falls, SD 57108-5475 | 2020-10-07 |
| 1437756905 | East Ridge Dental LLC | Clinic/Center | 518 N Sycamore Ave, Sioux Falls, SD 57110-5737 | 2020-10-07 |
| 1770055071 | Lifetime Dental Pllc | Clinic/Center | 2200 S Minnesota Ave, Sioux Falls, SD 57105-3748 | 2018-12-26 |
| 1447766100 | Freed Dental Prof. L.L.C. | Clinic/Center | 1709 E 10th St, Sioux Falls, SD 57103-1805 | 2017-12-18 |
| 1942690557 | Mark M Bierma Dds Ms, Pllc | Clinic/Center | 5000 S Broadband Ln, Ste 126, Sioux Falls, SD 57108-2260 | 2015-02-03 |
| 1790182822 | Wiswall Endodontics PC | Clinic/Center | 2333 W 57th St, Ste 103, Sioux Falls, SD 57108-5053 | 2014-12-04 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
Please comment or provide details below to improve the information on BOLEN FAMILY DENTISTRY P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.