Sebastian M Bouroncle DDS-3 Alexandria PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SEBASTIAN M BOURONCLE DDS-3 ALEXANDRIA PLLC

Practice address

5252 Dawes Ave
Alexandria, VA 22311-1404

Phone

(703) 933-8500

Fax

(703) 933-8506

NPI assigned

Aug 20, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Wendy Tavara

Title

Regional Manager

Phone

(703) 933-8500

Specialties & licenses 1

Addresses

Other names 1

• New Smiles Dental Alexandria Doing business as

Locations

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1114574654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 DAWES AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111404",
            "telephone_number": "703-933-8500",
            "fax_number": "703-933-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 DAWES AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111404",
            "telephone_number": "703-933-8500",
            "fax_number": "703-933-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTIAN M BOURONCLE DDS-3 ALEXANDRIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "TAVARA",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "703-933-8500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Smiles Dental Alexandria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Searfoss
• Michael D. Searles, LPC
• Ebonyammani Noelle Sears-Lentz
• Olga Sears, REGISTERED NURSE
• Seasons of Growth LLC
• Logan Sebastian, DPT
• Melinda Sebastian, M.D.
• Sedation Healthcare Specialists LLC
• Sedationmd Inc
• Gevorg Sedrakyan, MD

• General Practice Dentistry in Alexandria, VA
• Providers in Alexandria, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.