BOONYAPA PURT (NPI# 1609281997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609281997 |
| Entity Type | Individual |
| Full Name | BOONYAPA PURT |
| Credential | DMD |
| Practice Address |
2817 Reilly Rd Womack Army Medical Center Fort Bragg NC 28310 |
| Practice Telephone | 9109076000 |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2019-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
D10055 | OR | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
11294 | NC | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 11294 | NC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3551 Roger Brooke Dr, Brooke Army Medical Center, San Antonio, TX 782344504 | 2109161375 |
| Street Address |
2817 REILLY RD WOMACK ARMY MEDICAL CENTER |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982693792 | Colin M Greene | Family Medicine | 2817 Reilly Rd, Wamc Attn: Dccs, Fort Bragg, NC 28310-7324 | 2005-10-14 |
| 1720602824 | James Harter | Military Health Care Provider | 2817 Reilly Rd, Fort Bragg, NC 28310-7301 | 2020-06-04 |
| 1952925448 | John Kevin Fitzpatrick | Student in an Organized Health Care Education/Training Program | 2817 Reilly Rd, Fort Bragg, NC 28310-7301 | 2020-06-01 |
| 1396392601 | Alison Elizabeth Berglund | Physical Therapist | 2817 Reilly Rd, Fort Bragg, NC 28310 | 2019-08-21 |
| 1174091946 | Kerri Ann Henderson | Physical Therapist | 2817 Reilly Rd, Fort Bragg, NC 27332 | 2018-11-09 |
| 1487001483 | Janessa Renee England | Dermatology | 2817 Reilly Rd, Womack Army Medical Center, Fort Bragg, NC 28310 | 2016-05-19 |
| 1174998652 | Jessica Oseguera Emswiler | Pharmacist | 2817 Reilly Rd, Womack Army Medical Center, Fort Bragg, NC 28310 | 2015-12-09 |
| 1124422670 | Carrie E Lutzen | Nurse Practitioner | 2817 Reilly Rd, Womack Army Medical Center, Fort Bragg, NC 28310 | 2014-10-13 |
| 1497009138 | Leslie Fuentes | Nurse Practitioner | 2817 Reilly Rd, Womack Army Medical Center, Fort Bragg, NC 28310 | 2012-11-02 |
| 1194033506 | Angela Weston Feldtmann | Student in an Organized Health Care Education/Training Program | 2817 Reilly Rd, Fort Bragg, NC 28317 | 2010-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154960532 | Zammitti Gidaly Abrams Cohen & Associates, P.C. | Oral & Maxillofacial Surgery | 4009 Corning Pl Ste E3, Charlotte, NC 28216-1310 | 2020-01-02 |
| 1740611706 | Mark C. Austin Omfs, Pllc | Oral & Maxillofacial Surgery | 2001 South Baxter Drive, Leland, NC 28451 | 2013-12-02 |
| 1497931976 | Drs Coleman & Coleman | Oral & Maxillofacial Surgery | 19910 North Cove Rd, Cornelius, NC 28031 | 2008-01-15 |
| 1306042122 | Elda Lambert Fisher | Oral & Maxillofacial Surgery | Unc Hospitals 149 Brauer Hall Cb 7450, Chapel Hill, NC 27599-0001 | 2007-06-27 |
| 1508997883 | Carolina Surgical Arts Pa | Oral & Maxillofacial Surgery | 2516 Oakcrest Ave, Suite B, Greensboro, NC 27408-1932 | 2007-03-08 |
| 1659444776 | David Jason Mohorn | Oral & Maxillofacial Surgery | 408 Parkway, Suite A1, Greensboro, NC 27401-1661 | 2006-11-16 |
| 1154494284 | James W Belcher Jr. | Oral & Maxillofacial Surgery | 301 East Wendover Ave Suite 111, Piedmont Oral Maxillofacial Fac Ctr, Greensboro, NC 27401 | 2006-11-16 |
| 1841388188 | Allen Todd Smith | Oral & Maxillofacial Surgery | 1601 South Hawthorne Rd, Winston Salem, NC 27103-4127 | 2006-10-11 |
| 1447364666 | Dewey G Carter | Oral & Maxillofacial Surgery | 853 Heather Rd, Burlington, NC 27215-6288 | 2006-08-17 |
| 1821005976 | Asheville Radiology Associates | Oral & Maxillofacial Surgery | 84 Coxe Ave, Asheville, NC 28801-4167 | 2006-08-02 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
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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.