Alex Boucher, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN4730 Issued in ME

Practice address

309 Saint Thomas St Ste 213
Madawaska, ME 04756-1278

Phone

(207) 728-3971

NPI assigned

Jun 11, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1033778246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 ST JOHN RD",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047432208",
            "telephone_number": "207-521-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SAINT THOMAS ST STE 213",
            "city": "MADAWASKA",
            "state": "ME",
            "postal_code": "047561278",
            "telephone_number": "207-728-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "ALEX",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN4730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Andrew Barbour, PHARMD
• Tiffany Beaulieu, PT
• Heather A Berce, LCSW, CADC
• Michelle J Berube, LCSW
• Noelle Bouchard, PHARMD, LMT
• Jennifer Marie Bresett, FNP
• Inez Joan Butler, APRN
• Carl B Chasse, D.C., P.a.
• Carl Brian Chasse, DC
• Julie M Clavette

• General Practice Dentistry in Madawaska, ME
• Providers in Madawaska, ME by specialty
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.