NPIMap

Organization Active NPI

Sebastian M Bouroncle DDS4 Fredericksburg PLLC

Doing business as New Smiles Dental Fredericksburg

  • Dental Clinic/Center
  • Fredericksburg, VA
National Provider Identifier
1811770472
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SEBASTIAN M BOURONCLE DDS4 FREDERICKSBURG PLLC
Doing business as
New Smiles Dental Fredericksburg
Practice address
11111 Leavells Rd
Fredericksburg, VA 22407-5015
Phone
(540) 898-1747
NPI assigned
Aug 17, 2023
Last updated
Aug 17, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SEBASTIAN M BOURONCLE DDS4 FREDERICKSBURG PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Dr. Sebastian M Bouroncle, DDSNPI 1932245511
Title
Dentist Owner
Phone
(540) 898-1747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11111 Leavells Rd
Fredericksburg, VA 22407-5015

Mailing address

11111 Leavells Rd
Fredericksburg, VA 22407-5015
Phone (540) 898-1747

Other names 1

  • New Smiles Dental Fredericksburg Doing business as

National Provider Directory

National Provider Directory
Part of
Sebastian M Bouroncle DDS4 Fredericksburg PLLC

Locations

11111 Leavells Rd
Fredericksburg, VA 22407
Phone (540) 845-5342

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1811770472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 LEAVELLS RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075015",
            "telephone_number": "540-898-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 LEAVELLS RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075015",
            "telephone_number": "540-898-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTIAN M BOURONCLE DDS4 FREDERICKSBURG PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEBASTIAN M BOURONCLE DDS4 FREDERICKSBURG PLLC",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "BOURONCLE",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "540-898-1747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Smiles Dental Fredericksburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.