George James Bourekis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00007059 Issued in WA

Practice address

12409 E Mission Ave
Spokane Valley, WA 99216-3101

Phone

(509) 924-4411

Fax

(509) 924-2747

NPI assigned

Feb 20, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841335957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12409 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163101",
            "telephone_number": "509-924-4411",
            "fax_number": "509-924-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12409 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163101",
            "telephone_number": "509-924-4411",
            "fax_number": "509-924-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUREKIS",
        "first_name": "GEORGE",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00007059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "99063",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5016332",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Journey Bosley
• Sophia Bosse, RD, CD
• Aubrey Jean Bot
• Kathryn Bough, PHARMACY TECHNICIAN
• Helaina Yvonne Stanyer Boulieris, O.D.
• Brandon Boutain
• Omari Elizabeth Rose Boutain
• Dallon Bowen
• Kristina Bowen, M.D.
• Brittney Nicole Boyd, LMP

• General Practice Dentistry in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.