Provider Demographics
NPI:1821160045
Name:BOEHM, RICHARD ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANDREW
Last Name:BOEHM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16374 HOTCHKISS VALLEY RD E
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-6064
Mailing Address - Country:US
Mailing Address - Phone:865-986-3234
Mailing Address - Fax:865-988-6464
Practice Address - Street 1:16374 HOTCHKISS VALLEY RD E
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-6064
Practice Address - Country:US
Practice Address - Phone:865-986-3234
Practice Address - Fax:865-988-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9410122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist