Active NPI
Andrew Meena Boulos, DMD
- Dentist
- Ocala, FL
National Provider Identifier
1184357386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN27029
- Practice address
- 3411 SW 36TH Ter Unit 1
Ocala, FL 34474-7404 - Phone
- (352) 390-3699
- NPI assigned
- Jul 5, 2022
- Last updated
- Jul 5, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN27029 | FL | Primary |
Addresses
Primary practice location
3411 SW 36TH Ter Unit 1
Ocala, FL 34474-7404
Mailing address
2305 Foliage Oak Ter
Oviedo, FL 32766-7022
Phone (321) 266-0811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN27029 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1184357386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2305 FOLIAGE OAK TER",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327667022",
"telephone_number": "321-266-0811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3411 SW 36TH TER UNIT 1",
"city": "OCALA",
"state": "FL",
"postal_code": "344747404",
"telephone_number": "352-390-3699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULOS",
"first_name": "ANDREW",
"middle_name": "MEENA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-05",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN27029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.