Bassel Boulos
Dentist, General Practice in Roxbury, MA. Individual provider (NPI-1).
NPI number1467902155
StatusActive
Last updated in NPPESSep 20, 2019
Details
- NPI
- 1467902155
- Entity type
- Individual (NPI-1)
- Name
- Bassel Boulos
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 6, 2016
- Last updated
- Sep 20, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 04520 | NH | Yes |
Practice location
1290 Tremont StRoxbury, MA 02120-3432
Phone 617-427-1000
Mailing address
100 Bridge StPelham, NH 03076-3422
Phone 603-931-4698
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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