Provider Demographics
NPI:1932711769
Name:BOGY, HEATHER KATE (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:KATE
Last Name:BOGY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 NATALIE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:AR
Mailing Address - Zip Code:72079-9619
Mailing Address - Country:US
Mailing Address - Phone:870-489-4326
Mailing Address - Fax:
Practice Address - Street 1:86-260 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3128
Practice Address - Country:US
Practice Address - Phone:808-697-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2024-06-13
Deactivation Date:2024-05-29
Deactivation Code:
Reactivation Date:2024-06-13
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204473122300000X
HIDT-3165-0122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist