Breno Reboucas, D.D.S., D.SC.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DF11387 Issued in MA

Practice address

1463 Beacon St
Apt 34
Brookline, MA 02446-4737

Phone

(617) 901-2004

NPI assigned

Jun 30, 2010

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 MA

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Trustees of Boston University

  • Oral and Maxillofacial Surgery (Dentist)
  • Boston, MA
  • NPI 1154331916
  Medicare reassignment NPD

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1154632545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 BEACON ST",
            "address_2": "APT 34",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464737",
            "telephone_number": "615-601-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 BEACON ST",
            "address_2": "APT 34",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464737",
            "telephone_number": "617-901-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBOUCAS",
        "first_name": "BRENO",
        "name_prefix": "Dr.",
        "credential": "D.D.S., D.SC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DF11387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Watson Raymond, M.D.
• Anthony Edward Raynes, M.D.
• Reach Counseling Center, LLC
• Kendra Read, P.A.
• Rebecca Horne Pediatrics, LLC
• Milton Aaron Reder, M.D.
• Noel Anderson Redford
• Amy L Reed, MSW
• Michael K Rees, M.D.
• Stephen Reese, MD

• Pediatric Dentistry in Brookline, MA
• Providers in Brookline, MA by specialty
• Pediatric Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.