Nicholas Andre Khoury

Primary specialty

DentistTaxonomy code 122300000X

License

1376243683 Issued in MA

Practice address

968 Main St
Wakefield, MA 01880-3989

Phone

(781) 549-8390

NPI assigned

Mar 6, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1376243683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 MISHAWUM RD UNIT 5041",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012280",
            "telephone_number": "603-475-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803989",
            "telephone_number": "781-549-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "NICHOLAS",
        "middle_name": "ANDRE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "1376243683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Kenney
• Maureen Kenny-Woodworth, LICSW
• Kevin J. McNeil, D.D.S.
• Yeva Khachatryan, PHARMD
• Jasmine Mahmoud Khamis, ED.M
• John Graydon Kidd, M.D.
• Milly Namazi Kikabi
• Eda Kil
• Kirsten Kilburn
• Courtney Elizabeth Kilgore

• Dentist in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.