Anil K. Bouri Jr., D.D.S., M.S.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Practice address

465 S Spring Rd
Elmhurst, IL 60126-5805

Phone

(630) 530-4710

Fax

(630) 530-4724

NPI assigned

Jan 29, 2007

Last updated

Jul 8, 2007By 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

Other names 1

• Dr. Anil K. Bouri Jr. Professional name

Medicare fee-for-service enrollment

Enrolled in IL

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093851875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 S SPRING RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265805",
            "telephone_number": "630-530-4710",
            "fax_number": "630-530-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 S SPRING RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265805",
            "telephone_number": "630-530-4710",
            "fax_number": "630-530-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURI",
        "first_name": "ANIL",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANIL",
            "last_name": "BOURI",
            "middle_name": "K.",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "D.D.S., M.S.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Barbara Jane Bosslet, MA CCC-SLP/L
• Tessa Botka
• Corina Bottcher
• Stephen William Boudro, D.C.
• Meghan Bounsay
• Nicholas John Bournazos, D.C.
• Christopher A Boutin, MD
• Ruth Bowhay, LCSW
• Meredith Brackett
• Mary M Bradley, APRN

• Periodontics in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.