Alexander Bouneff, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D11586 Issued in OR

Practice address

3925 SW 153Rd Dr Ste 100
Beaverton, OR 97003-4168

Phone

(503) 646-7101

NPI assigned

May 4, 2017

Last updated

Sep 8, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 26, 2026 through May 26, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beaverton Oral Surgeons Equipment LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Beaverton, OR
  • NPI 1730229774
  NPD
• Beaverton Oral Surgeons

  • Oral and Maxillofacial Surgery Clinic/Center
  • Beaverton, OR
  • NPI 1811121932
  NPD (past)
• Dr Nassif and Associates Inc

  • General Practice Dentistry
  • Lyndhurst, OH
  • NPI 1982026688
  NPD (past)
• DRS Marino Nassif & Associates Inc

  • General Practice Dentistry
  • Lyndhurst, OH
  • NPI 1093824617
  NPD (past)

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1235665738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NW 11TH AVE UNIT 1001",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092972",
            "telephone_number": "971-241-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 SW 153RD DR STE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970034168",
            "telephone_number": "503-646-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUNEFF",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D11586",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arely Botello Leal
• Olivia Suzanne Botsford
• Carole Jean Bottoms
• Samantha Boulanger
• Bounce Back Acupuncture
• Anthony B. Bouneff, D.M.D.
• Lisa Ann Bourlon
• Robin Jeanne Bousquet, MPT
• Benjamin L Bowers, LMT
• Kayla Strong Bowling

• Oral and Maxillofacial Surgery (Dentist) in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.