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BOULDER ROCK DENTAL, LLC
NPI 1922515204
Dentist - General Practice in Palm Coast, FL

Active since January 08, 2018
5 BOULDER ROCK DR STE A, PALM COAST, FL 32137(386) 931-1685 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2024, Jan 8, 2018 (2 updates tracked since 2018).

About Boulder Rock Dental, Llc NPPES

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

BOULDER ROCK DENTAL, LLC (NPI 1922515204) is a healthcare organization registered as a general practice in Palm Coast, Florida and active in the NPI registry since January 2018. The organization lists Tanya Whitaker, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1922515204
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBOULDER ROCK DENTAL, LLC
Location Address5 BOULDER ROCK DR STE APalm Coast, FL 32137-8538
Mailing Address5 Boulder Rock Dr Ste APalm Coast, FL 32137-8538 · (386) 276-9051 · Fax (386) 276-9053
Phone(386) 931-1685
Organization SubpartNo
Authorized OfficialTanya WhitakerOffice Manager · (386) 276-9051
Enumeration DateJanuary 8, 2018
Last NPPES UpdateJune 12, 20242 updates tracked since enumeration
NPPES CertifiedJune 12, 2024
✔ NPI 1922515204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in FL · DN15016
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
5 BOULDER ROCK DR STE A, Palm Coast, FL 32137
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 3

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

DR. TYLER SCOTT FLYNN DMD
Dentist
5 BOULDER ROCK DR STE A
PALM COAST, FL 32137
Flagler County (386) 276-9051
THINH D TRAN
Dentist
5 BOULDER ROCK DR STE A
PALM COAST, FL 32137
Flagler County (386) 282-8884
THOMAS HUNTLEY DMD
Dentist (General Practice)
5 BOULDER ROCK DR STE A
PALM COAST, FL 32137
Flagler County (386) 276-9051

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 Boulder Rock Dental, LLC's NPI number?

The NPI number for Boulder Rock Dental, LLC is 1922515204. It was assigned to this organization in the NPPES registry on January 8, 2018.

Where is Boulder Rock Dental, LLC located?

Boulder Rock Dental, LLC is located at 5 Boulder Rock Dr Ste A, Palm Coast, FL 32137. The listed phone number is (386) 931-1685.

What is Boulder Rock Dental, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Boulder Rock Dental, LLC accept?

Health plans from Ambetter Health, Ambetter of Alabama and UnitedHealthcare list Boulder Rock Dental, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Boulder Rock Dental, LLC was last updated on June 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.