Alexandra Boudreau, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8964 Issued in NC

Practice address

105 Perry Dr
Southern Pines, NC 28387-7019

Phone

(910) 692-5111

Fax

(910) 692-1003

NPI assigned

Jun 8, 2010

Last updated

Jun 8, 2010By the provider in NPPES

Sex

Female

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 NC

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

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.

• Firsthealth of the Carolinas, Inc.

  dba FirstHealth Dental Care

  • Dental Clinic/Center
  • Southern Pines, NC
  • NPI 1699755686
  NPD (past)

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1316267701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PERRY DR",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877019",
            "telephone_number": "910-692-5111",
            "fax_number": "910-692-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PERRY DR",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877019",
            "telephone_number": "910-692-5111",
            "fax_number": "910-692-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "ALEXANDRA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Jane Bonecutter
• Katherine Bonilla
• Carol Borsman
• Olivia Bortz
• Taylor Michael Bosley, DO
• Sarah Danielle Bowen-Pasfield, M.D.
• Lani Bozkurt, BCTP, CDS
• Bradford Associates
• Shalinda Brewer, RBT
• Sarah Locklear Brewington, M.D.

• Dentist in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.