Active NPI
Boshra Peyrovi
- General Practice Dentistry
- Montgomery Village, MD
National Provider Identifier
1942885934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17293
- Practice address
- 19644 Club House Rd Ste 810
Montgomery Village, MD 20886-3047 - Phone
- (240) 543-4390
- NPI assigned
- Mar 11, 2021
- Last updated
- Mar 11, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17293 | MD | Primary |
Addresses
Primary practice location
19644 Club House Rd Ste 810
Montgomery Village, MD 20886-3047
Mailing address
18929 N Meadow Fence Rd
Gaithersburg, MD 20886-3152
Phone (240) 543-4390
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 |
|---|---|---|---|
| 17293 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1942885934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18929 N MEADOW FENCE RD",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208863152",
"telephone_number": "240-543-4390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19644 CLUB HOUSE RD STE 810",
"city": "MONTGOMERY VILLAGE",
"state": "MD",
"postal_code": "208863047",
"telephone_number": "240-543-4390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEYROVI",
"first_name": "BOSHRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-11",
"last_updated": "2021-03-11",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "17293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery Village, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.