Individual provider Active NPI

Bassima Bashour, BASSIMA BASHOUR

  • Dentist
  • Weston, MA
National Provider Identifier
1669677746
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20009 Issued in MA
Practice address
70 Conant Rd
Weston, MA 02493-3131
Phone
(617) 981-9952
NPI assigned
Jun 18, 2007
Last updated
Sep 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20009 MA Primary

Addresses

Primary practice location

70 Conant Rd
Weston, MA 02493-3131

Mailing address

70 Conant Rd
Weston, MA 02493-1035
Phone (617) 981-9952

Other names 1

  • Bassima Connelly Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20009MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1669677746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 CONANT RD",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931035",
            "telephone_number": "617-981-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CONANT RD",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024933131",
            "telephone_number": "617-981-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHOUR",
        "first_name": "BASSIMA",
        "name_prefix": "Dr.",
        "credential": "BASSIMA BASHOUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "20009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BASSIMA",
            "last_name": "CONNELLY",
            "credential": "BASSIMA BASHOUR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.