Individual provider Active NPI

Rany Bous, BDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Cleveland, OH
National Provider Identifier
1679923023
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
RES.3643 Issued in OH
Practice address
2124 Cornell Rd
Cleveland, OH 44106-3804
Phone
(216) 368-3200
NPI assigned
Jun 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X RES.3643 OH Primary

Addresses

Primary practice location

2124 Cornell Rd
Cleveland, OH 44106-3804

Mailing address

2124 Cornell Rd
Cleveland, OH 44106-3804
Phone (216) 368-3200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191101000899 OH Order and Referring Only - DentistPractitioner - Dentist 9133451677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RES.3643OHMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center of Akron Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1679923023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 CORNELL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441063804",
            "telephone_number": "216-368-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CORNELL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441063804",
            "telephone_number": "216-368-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUS",
        "first_name": "RANY",
        "credential": "BDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "RES.3643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.