George Boughan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4505 Issued in AZ

Practice address

2554 W 16TH St
Yuma, AZ 85364-4229

Phone

(520) 334-7995

NPI assigned

Feb 21, 2007

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

Medicare fee-for-service enrollment

Enrolled in AZ

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1508901778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 W 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 W 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644229",
            "telephone_number": "520-334-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGHAN",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D4505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristofer Bonar
• Luis Ruben Bonilla, LPC
• Reyna Bonilla, LPC
• Kusalik Boppana, MD
• Gina Botello, FNP
• Kimberlee A Bowie, B.S.
• Virgina Dawn Bowling, FOSTER PARENT
• Shiann Joy Bowman
• Mikayla D Boyd
• Abigail Boynton

• General Practice Dentistry in Yuma, AZ
• Providers in Yuma, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.