Pierre Bassem Boulos Ghobrial, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

7437 Issued in NV

Practice address

7125 N Durango Dr
Las Vegas, NV 89149-4466

Phone

(702) 658-2311

NPI assigned

Feb 18, 2021

Last updated

Mar 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elnaggar DDS Inc

  dba St. Mark Family Dental

  • Dentist
  • Canoga Park, CA
  • NPI 1427447028
  NPD
• Watanabe Town Center Dental Group, Professional Corporation

  dba Montecito Town Center Dental Group

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1104954833
  NPD (past)

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1821681164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 VARIEL AVE APT 233",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913034801",
            "telephone_number": "857-654-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 N DURANGO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494466",
            "telephone_number": "702-658-2311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20913 Sherman Way",
            "address_purpose": "LOCATION",
            "city": "Canoga Park",
            "state": "CA",
            "postal_code": "913031743",
            "country_code": "US",
            "telephone_number": "818-992-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOBRIAL",
        "first_name": "PIERRE",
        "middle_name": "BASSEM BOULOS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105974",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "2.012997",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858898",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "37000",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pgdmd20@bu.edu",
            "affiliation": "N",
            "address_1": "20913 Sherman Way",
            "city": "Canoga Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913031743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ciro Ghiraldi, DC
• Medhin Ghirmai
• Yonatan Ghiwot, MD
• Conor Ghobrial
• Michael Gergis Ghobrial, MD
• Youssef Ghobrial
• Soheila Ghods
• Sharam Ghodsi, DDS
• Rashin Gholamrezaee, MD
• Afshin Gholamrezaei

• Dentist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.