Rafik Boulos

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17085 Issued in MD

Practice address

8501 Lasalle Rd
306
Towson, MD 21286

Phone

(410) 296-7599

NPI assigned

Sep 19, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776556800000",
    "number": "1053961276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 LIGON RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425241",
            "telephone_number": "410-900-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 LASALLE RD",
            "address_2": "306",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21286",
            "telephone_number": "410-296-7599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8140 Corporate Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nottingham",
            "state": "MD",
            "postal_code": "212366902",
            "country_code": "US",
            "telephone_number": "410-900-3882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "RAFIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Bottega
• Frank J Bottiglieri, MD
• Miranda Grace Boucard, ATC
• Laura Rachel Boudman, LMSW
• Grace Boudris
• Donna Bourn, CRNA
• Christina Bowden
• Robert Bowen, PMHNP-BC
• Judy Bowling, O.T.
• Renee Ashley Bowman, CRNP

• General Practice Dentistry in Towson, MD
• Providers in Towson, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; 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.