Active NPI
Boulos Bechara, DDS, MS
- Oral and Maxillofacial Radiology Dentistry
- Kennewick, WA
National Provider Identifier
1679913578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Radiology Dentistry
- License
- 28866
- Practice address
- 35508 S Valley Vista PR SE
Kennewick, WA 99338-9431 - Phone
- (509) 566-4334
- NPI assigned
- Jun 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X | 28866 | TX | Primary |
Addresses
Primary practice location
35508 S Valley Vista PR SE
Kennewick, WA 99338-9431
Mailing address
7811 Chambers Rd
Apt. #525
San Antonio, TX 78229-2671
Phone (210) 218-9683
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28866 | TX | MD | Oral and Maxillofacial Radiology Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1679913578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7811 CHAMBERS RD",
"address_2": "APT. #525",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782292671",
"telephone_number": "210-218-9683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35508 S VALLEY VISTA PR SE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993389431",
"telephone_number": "509-566-4334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECHARA",
"first_name": "BOULOS",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-25",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0008X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Radiology",
"state": "TX",
"license": "28866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.