Trevor A Bourgeois, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

21988 Issued in OH

Practice address

5400 N High St
Columbus, OH 43214-1117

Phone

(614) 436-2817

Fax

(614) 436-3954

NPI assigned

Dec 10, 2008

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 OH

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": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1659516243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141117",
            "telephone_number": "614-436-2817",
            "fax_number": "614-436-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141117",
            "telephone_number": "614-436-2817",
            "fax_number": "614-436-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "TREVOR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "21988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Ann Bouquet, MD
• Tifanny Bourdon Garzon
• Eric C Bourekas, MD
• Brian P Bourgeois, DDS
• Frederick Wayne Bourgeois, DDS
• Rachael Erin Bourget
• Jamie Bourn
• Jon Bourn, PH.D.
• Michael V Bourn, DO
• Brittany Nicole Bourne, APRN-CNP

• Dentist in Columbus, OH
• Providers in Columbus, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.