Individual provider Active NPI

Boula Zakria Adly Morkos

  • Dentist
  • Oxnard, CA
National Provider Identifier
1245938208
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109554 Issued in CA
Practice address
1200 Saviers Rd
Oxnard, CA 93033-1732
Phone
(805) 248-7070
NPI assigned
Feb 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109554 CA Primary

Addresses

Primary practice location

1200 Saviers Rd
Oxnard, CA 93033-1732

Mailing address

8442 Henderson Rd
Ventura, CA 93004-2167
Phone (805) 256-5354

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251226000099 IL Order and Referring Only - DentistPractitioner - Dentist 0648766832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109554CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Dental Services, Inc. Dentist PastSince Oct 22, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1245938208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8442 HENDERSON RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930042167",
            "telephone_number": "805-256-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SAVIERS RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930331732",
            "telephone_number": "805-248-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORKOS",
        "first_name": "BOULA",
        "middle_name": "ZAKRIA ADLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.