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JILLISA BOLLER DENTAL ASSISTANT X2
NPI 1750730446
Dental Assistant in Fort Drum, NY

Active since June 03, 2016
10590 ENDURING FREEDOM DR, FORT DRUM, NY 13602(315) 772-6234 Get Directions Write a Review

NPPES record last updated: June 3, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jillisa Boller Dental Assistant X2 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JILLISA BOLLER DENTAL ASSISTANT X2 (NPI 1750730446) is an individual dental assistant in Fort Drum, New York and active in the NPI registry since June 2016.

NPPES Registry Identity

NPI1750730446
Entity TypeIndividualFemale
Primary Taxonomy126800000X
Provider Legal NameJILLISA BOLLERCredential: DENTAL ASSISTANT X2
Location Address10590 ENDURING FREEDOM DRFort Drum, NY 13602-5005
Mailing Address10590 Enduring Freedom DrFort Drum, NY 13602-5005 · (315) 772-6234
Phone(315) 772-6234
Sole ProprietorYes
Enumeration DateJune 3, 2016
✔ NPI 1750730446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDental AssistantDental Providers
Taxonomy Code126800000X
Definition
An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary.
10590 ENDURING FREEDOM DR, Fort Drum, NY 13602
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MARY BICE DENTALASSISTANT EFDA
Dental Assistant
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-6234
BRITTON STERLING BECKSTEAD DDS
Dentist (Dental Public Health)
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-5576
MRS. ROXANNE LAWLER DENTAL HYGIENIST
Dental Hygienist
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-6234
MARK ROBERT VOELKER DMD
Dentist
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-5576
MAHBUBA RAHMAN DDS
Dentist
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-5576
DR. RALF BEILHARDT DDS
Dentist (General Practice)
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-4342
MRS. NELLY GUTIERREZ DENTAL ASSISTANTEFDA
Dental Assistant
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-6234
MS. KIMBERLYN JOY SICKLER RDH
Dental Hygienist
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602
Jefferson County (315) 772-5576

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jillisa Boller's NPI number?

The NPI number for Jillisa Boller is 1750730446. It was assigned to this individual provider in the NPPES registry on June 3, 2016.

Where is Jillisa Boller located?

Jillisa Boller practices at 10590 Enduring Freedom Dr, Fort Drum, NY 13602. The listed phone number is (315) 772-6234.

What is Jillisa Boller's specialty?

The primary specialty registered for this NPI is Dental Assistant with taxonomy code 126800000X.

When was this NPI record last updated?

The NPPES record for Jillisa Boller was last updated on June 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.