Active NPI
Atef Boutros DDS Inc.
- General Practice Dentistry
- Long Beach, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- ATEF BOUTROS DDS INC.
- Practice address
- 1183 E Anaheim Street
Long Beach, CA 90813 - Phone
- (562) 912-4367
- Fax
- (562) 912-4369
- NPI assigned
- Jan 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Atef A Boutros, DDS
- Title
- Dentist
- Phone
- (562) 912-4367
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
1183 E Anaheim Street
Long Beach, CA 90813
Mailing address
1183 E Anaheim Street
Long Beach, CA 90813
Phone (562) 912-4367
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G93926-01 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
1183 E Anaheim St
Long Beach, CA 90813
Phone (562) 912-4367
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Long Beach, CA
- NPI 1619024775
-
- Dentist
- Los Angeles, CA
- NPI 1841673936
-
- Dentist
- East Los Angeles, CA
- NPI 1780137091
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1316114234
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1003074923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698105600000",
"number": "1639229099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1183 E ANAHEIM STREET",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90813",
"telephone_number": "562-912-4367",
"fax_number": "562-912-4369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1183 E ANAHEIM STREET",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90813",
"telephone_number": "562-912-4367",
"fax_number": "562-912-4369"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATEF BOUTROS DDS INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-10",
"last_updated": "2023-10-24",
"status": "A",
"authorized_official_last_name": "BOUTROS",
"authorized_official_first_name": "ATEF",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "562-912-4367",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G93926-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.