DR. GEORGE C BOHLE III (NPI# 1124003744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124003744 |
| Entity Type | Individual |
| Full Name | DR. GEORGE C BOHLE III |
| Credential | DDS |
| Practice Address |
4517 Memorial Cir Oklahoma City OK 73142-5006 |
| Practice Telephone | 4057557777 |
| Practice Fax Number | 4057557169 |
| Mailing Telephone | 4057557777 |
| Mailing Fax Number | 4057557169 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2012-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
33 | OK | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
48870 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629384870 | George Charles Bohle Jr. | Pharmacist | 6300 Georgetown Blvd, Eldersburg, MD 21784-6481 | 2010-08-25 |
| Street Address |
4517 MEMORIAL CIR |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73142-5006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588658470 | Lars Olav Bouma | Dentist | 4517 Memorial Cir, Oklahoma City, OK 73142-5004 | 2005-09-07 |
| 1821228214 | Implant & Prosthodontic Associates, Pllc | Dentist | 4517 Memorial Cir, Oklahoma City, OK 73142-5006 | 2009-07-20 |
| 1821007337 | Thomas J Mcgarry Vii | Dentist | 4517 Memorial Cir, Oklahoma City, OK 73142-5004 | 2006-08-05 |
| 1477562999 | Susan Elizabeth Brackett | Dentist | 4517 Memorial Cir, Oklahoma City, OK 73142-5004 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184003790 | Advance Physicians Group LLC | Clinic/Center | 13401 N Macarthur Blvd, Oklahoma City, OK 73142 | 2015-05-28 |
| 1366840084 | Lindsey Jackson | Case Manager/Care Coordinator | 12051 Parkland Pl, Oklahoma City, OK 73142 | 2014-12-11 |
| 1164866737 | Vitality Wellness | Clinic/Center | 5740 Nw 135th St., Oklahoma City, OK 73142 | 2013-04-25 |
| 1356694558 | Joel Mitchell Sprinkle | Community Health Worker | 13100 Brandon Pl, Oklahoma City, OK 73142 | 2012-10-25 |
| 1689923856 | Sampson Mcsidney | Case Management | 14717 Hollyhock Dr, Oklahoma City, OK 73142 | 2012-09-04 |
| 1992087860 | Derek Reed Mccarver | Pharmacist | 1400 E. 2nd St, Edmond, OK 73142 | 2011-09-15 |
| 1326335811 | Laser Spine Surgery Center of Oklahoma, LLC | Clinic/Center | 4727 Gaillardia Parkway, Suite 150, Oklahoma City, OK 73142 | 2011-07-05 |
| 1215220801 | James Kenneth Fisher | Psychologist | 12522 Abbotts Way, Oklahoma City, OK 73142 | 2011-05-16 |
| 1174850408 | Diagnostic Laboratory of Oklahoma, LLC | Clinical Medical Laboratory | 5911 West Memorial Road, Oklahoma City, OK 73142 | 2009-11-06 |
| 1417113275 | Reuben Seth Thomas | Optometrist | 6200 W Memorial Rd Ste A, Oklahoma City, OK 73142 | 2008-07-31 |
| Find all providers in zip 73142 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477927085 | Justin Pisano | Dentist | 429 Nw 11th St, Apt 6, Oklahoma City, OK 73103-3927 | 2015-11-19 |
| 1558776989 | Daniel Szalay | Dentist | 1201 N Stonewall Ave Ste 206, Oklahoma City, OK 73117-1214 | 2014-06-24 |
| 1649690025 | Andrew Mcgarry | Dentist | 10900 Hefner Pointe Dr Ste 204, Oklahoma City, OK 73120 | 2014-04-23 |
| 1538391214 | Mayflower Oral and Maxillofacial Surgery Pllc | Dentist | 5600 N May Ave, Suite 250, Oklahoma City, OK 73112-3973 | 2009-08-14 |
| 1962523100 | University Oral & Maxillofacial Surgeons | Dentist | 1201 North Stonewall Avenue, Oklahoma City, OK 73117 | 2007-04-03 |
| 1649313206 | Anil K Kashyap | Dentist | 920 Stanton L Young Blvd Dept, Wp-2140, Oklahoma City, OK 73104-5036 | 2007-02-14 |
| 1497894604 | Zeneida G Vasquez Dds PC | Dentist | 1224 Sw 104th St, Suite B, Oklahoma City, OK 73139-3020 | 2007-02-05 |
| 1073681789 | James Andrew Wendelken | Dentist | 3727 Nw 63 Street, Suite 300, Oklahoma City, OK 73116 | 2006-12-01 |
| 1043384357 | William M. Croom | Dentist | 1201 N Stonewall Ave # Dcsb206, Oklahoma City, OK 73117-1214 | 2006-11-20 |
| 1841371010 | Michael Duffy | Dentist | 1201 N Stonewall Ave Ste 230, Oklahoma City, OK 73117 | 2006-10-17 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73142 |
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| 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.