Active NPI
Steven Wilfred-Earle Boucher, DMD
- Dentist
- Fall River, MA
National Provider Identifier
1861975989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1858123
- Practice address
- 38 Gaudette Dr
Fall River, MA 02721-4528 - Phone
- (508) 567-2573
- NPI assigned
- Sep 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN23745 | FL | |
| Dentist | 122300000X | DN1858123 | MA | Primary |
Addresses
Primary practice location
38 Gaudette Dr
Fall River, MA 02721-4528
Mailing address
38 Gaudette Dr
Fall River, MA 02721-4528
Phone (508) 567-2573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN23745 | FL | MD | Dentist |
| DN1858123 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538352000000",
"number": "1861975989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 GAUDETTE DR",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027214528",
"telephone_number": "508-567-2573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 GAUDETTE DR",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027214528",
"telephone_number": "508-567-2573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCHER",
"first_name": "STEVEN",
"middle_name": "WILFRED-EARLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-14",
"last_updated": "2018-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN23745",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1858123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.