A. Farid Bolouri DMD, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

A. FARID BOLOURI DMD, PC

Practice address

11080 SE Oak St
Milwaukie, OR 97222-6692

Phone

(503) 654-0613

NPI assigned

Oct 28, 2022

Last updated

Oct 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Irma Starr

Title

Office Manager

Phone

(503) 654-0613

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1558078600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11080 SE OAK ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226692",
            "telephone_number": "503-654-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11080 SE OAK ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226692",
            "telephone_number": "503-654-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A. FARID BOLOURI DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-654-0613"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.