Adam Boustany, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4338 Issued in WV

Practice address

2017 E Pike St
Clarksburg, WV 26301-6013

Phone

(304) 623-9188

NPI assigned

Jun 18, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• All Smiles Dental LLC

  • General Practice Dentistry
  • Clarksburg, WV
  • NPI 1992698153
  NPD
• Amy Everett DDS and Associates PLLC

  • Dentist
  • Morgantown, WV
  • NPI 1245340355
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1699269233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 RAVEN RUN",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265089297",
            "telephone_number": "304-941-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 E PIKE ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263016013",
            "telephone_number": "304-623-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSTANY",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Adrienna Bongiorni, PHARMD
• Rebecca Diane Bonnett
• Sherry Bonnette
• Jacqueline Sue Borror
• Carmen Nicole Boso, M.S.
• Erin Bowen
• Stephanie Ann Bowers
• William G. Bowles, D.O.
• Caitlin Marie Boyce
• Jada Boyles

• General Practice Dentistry in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.