Adly Zekry Boulos, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

034547 Issued in NY

Practice address

3123 Coney Island Ave
Brooklyn, NY 11235-6468

Phone

(718) 646-4200

Fax

(718) 646-4201

NPI assigned

Nov 17, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457333130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356468",
            "telephone_number": "718-646-4200",
            "fax_number": "718-646-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3123 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356468",
            "telephone_number": "718-646-4200",
            "fax_number": "718-646-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "ADLY",
        "middle_name": "ZEKRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "034547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00460444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathalie Bouillon, LMSW
• Zakaria Boukhatem, DMD
• Jonathan Bouknight, LMHC
• Boulevard Adult Day Care of Flushing
• Germaine Boulin, LMSW
• Georgios Bouloukakis, MD, MS
• Bishoy Ibrahim Boulus Elkoumes, MD
• Kourtney Lee Bouma
• Adrienna Boumoussa, MD
• Viktoria Bounitch, DDS

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.