NPIMap

Organization Active NPI

Charles Khoury, DMD, Inc.

  • Dental Clinic/Center
  • Fairhaven, MA
National Provider Identifier
1043309941
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
20015 Issued in MA
Legal business name
CHARLES KHOURY, DMD, INC.
Practice address
404 Huttleston Ave
1St Floor
Fairhaven, MA 02719
Phone
(508) 997-7776
NPI assigned
Oct 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles Khoury, DMDNPI 1124000393
Title
President
Phone
(508) 997-7776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 20015 MA Primary

Addresses

Primary practice location

404 Huttleston Ave
1St Floor
Fairhaven, MA 02719

Mailing address

1428 Dartmouth Woods Drive
Dartmouth, MA 02747

Other identifiers 1

IdentifierTypeStateIssuer
X12286OtherMABCBS OF MA

National Provider Directory

National Provider Directory

Locations

404 Huttleston Ave
#1
Fairhaven, MA 02719
Phone (508) 997-7776

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043309941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 DARTMOUTH WOODS DRIVE",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "02747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 HUTTLESTON AVE",
            "address_2": "1ST FLOOR",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "02719",
            "telephone_number": "508-997-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES KHOURY, DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-997-7776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "20015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "X12286",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhaven, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.