George Boukas

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30.027032 Issued in OH

Practice address

4526 Glen Eagle Dr
Brecksville, OH 44141-2934

Phone

(336) 337-8492

NPI assigned

Feb 22, 2021

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Strongsville Pediatric Dentistry

  • Pediatric Dentistry
  • Strongsville, OH
  • NPI 1245176858
  NPD Authorized official
• Thriving Smiles LLC

  dba Thriving Smiles Pediatric Dentistry

  • Dental Clinic/Center
  • North Ridgeville, OH
  • NPI 1972204550
  NPD Authorized official

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1285228197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 GLEN EAGLE DR",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441412934",
            "telephone_number": "336-337-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUKAS",
        "first_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-22",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.027032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Therese Bohn-Galas, LISW
• Enzo Bolzan, PHARMD
• Linda Christine Bond, M.D.
• Stephanie Jo Bonnizzio, RPH
• Mary Catherine Borovicka, PHARM.D.
• Megan M Boulton
• Bourquecorp (comfort keepers)
• Mark William Bowers
• Bradley Warren Hylan DMD Brecksville
• Edward Stephen Brandon, D.D.S.

• Pediatric Dentistry in Brecksville, OH
• Providers in Brecksville, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.