Koury Louis Bonds, DDS
Individual provider Active NPI General Practice Dentistry · Washington, DC
NPI 1790739274 · NPPES record last updated Jan 28, 2011
Key facts
- NPI
- 1790739274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DEN1000957 (DC)
- Practice address
- 3401 Georgia Ave NW
Washington, DC 20010-2501 - Phone
- (202) 829-5437
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN1000957 | DC | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 052691 | NY | |
| General Practice Dentistry | 1223G0001X | DEN1000957 | DC | Yes |
Addresses
Primary practice location
3401 Georgia Ave NW
Washington, DC 20010-2501
Mailing address
201 W 8TH St
Suite 810
Pueblo, CO 81003-3038
Phone (719) 562-4447
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02742074 | Medicaid | NY | |
| 9181990 | Other | NY | DORAL |
Other providers in Washington, DC
- Wendy Bond
- William Rhoden Bond Jr.
- Allison Bondanza
- Menen Borena Bondoche
- Kayla Bonds
- Whitney Bianca Larkin Bonds
- Andre Boney
- Finitta Boney
- Samira Marsha Boney
- Hadassah Esther Bong
All providers in Washington, DC · General Practice Dentistry in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.