Kerri A Bourgeois, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN22202 Issued in MA

Practice address

1864 Centre St Ste 2
West Roxbury, MA 02132-1919

Phone

(617) 390-5371

NPI assigned

Aug 10, 2007

Last updated

Aug 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 MA

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": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1760674030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 WOODSIDE LN",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024742152",
            "telephone_number": "781-646-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 CENTRE ST STE 2",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021321919",
            "telephone_number": "617-390-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "KERRI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN22202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl R Borrelli, RN
• Boston VA Healthcare System
• Boston Vamc
• Boston Vamc
• Susan Sabarre Bostrom, LPN
• Joey Boyer, RN 237173
• Alyson Mackenzie Bracken, P.A.
• Mary Ellen Brady, MS RT(T)
• Jill Elizabeth Braganca, MD
• Parbati Basu Brahma, M.D.

• Dentist in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.