Active NPI
Peter N Bougas Jr.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Snellville, GA
National Provider Identifier
1881829752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 9333
- Practice address
- 2381 Main St E Ste a
Snellville, GA 30078-3358 - Phone
- (770) 979-5300
- Fax
- (770) 978-5928
- NPI assigned
- May 21, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 9333 | FL | Primary |
Addresses
Primary practice location
2381 Main St E Ste a
Snellville, GA 30078-3358
Mailing address
2381 Main St E Ste a
Snellville, GA 30078-3358
Phone (770) 979-5300
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 |
|---|---|---|---|
| 9333 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242864000000",
"number": "1881829752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2381 MAIN ST E STE A",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300783358",
"telephone_number": "770-979-5300",
"fax_number": "770-978-5928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2381 MAIN ST E STE A",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300783358",
"telephone_number": "770-979-5300",
"fax_number": "770-978-5928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUGAS",
"first_name": "PETER",
"middle_name": "N",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-21",
"last_updated": "2009-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "9333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snellville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.