Nagwa Boutros Fanous, D.M.D.PC

Primary specialty

DentistTaxonomy code 122300000X

License

MA15660 Issued in MA

Legal business name

NAGWA BOUTROS FANOUS, D.M.D.PC

Practice address

2 S Main St
Milford, MA 01757-3250

Phone

(508) 478-0106

Fax

(508) 478-3247

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Nagwa Fanous, D.M.D.

Title

Owner

Phone

(508) 478-0106

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1386845709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S MAIN ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573250",
            "telephone_number": "508-478-0106",
            "fax_number": "508-478-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S MAIN ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573250",
            "telephone_number": "508-478-0106",
            "fax_number": "508-478-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAGWA BOUTROS FANOUS, D.M.D.PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "FANOUS",
        "authorized_official_first_name": "NAGWA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-478-0106",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "MA15660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0264091",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Myers
• Viji Nadarajah
• Joseph Nadeau
• Maizie Gao Naegelin II
• Lindsay Rose Nagle
• Fatima Zahra Naidjate
• Andrea Nanco Gonzalez
• Nancy Altman, LLC
• Spoorthi Narayana
• Rasha Ragaey Nashed, MASTER

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.