Reaching Out Ministries

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D927 Issued in GU

Legal business name

REACHING OUT MINISTRIES

Doing business as

Paradise Smiles Dental Clinic

Practice address

226 Chalan San Antonio Ste C
Amparo's Business Center
Tamuning, GU 96913-3525

Phone

(671) 646-2010

Fax

(671) 646-2070

NPI assigned

Jul 22, 2009

Last updated

Jul 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenny Wayne Bourgeois, DDS

Title

President/Primary Dental Provider

Phone

(671) 646-2010

Specialties & licenses 2

Addresses

Other names 1

• Paradise Smiles Dental Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Wayne Bourgeois, DDS

  • General Practice Dentistry
  • Tamuning, GU
  • NPI 1255561320
  NPD (past)

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1972733053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 CHALAN SAN ANTONIO STE C",
            "address_2": "AMPARO'S BUSINESS CENTER",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133525",
            "telephone_number": "671-646-2010",
            "fax_number": "671-646-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 CHALAN SAN ANTONIO STE C",
            "address_2": "AMPARO'S BUSINESS CENTER",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133525",
            "telephone_number": "671-646-2010",
            "fax_number": "671-646-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REACHING OUT MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "BOURGEOIS",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT/PRIMARY DENTAL PROVIDER",
        "authorized_official_telephone_number": "671-646-2010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "14605",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GU",
            "license": "D927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Smiles Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirstin Maree Anderson Raguindin, DO
• Kia M Rahmani, M.D.
• Gia Stella B Ramos, RN
• Raisa Ashley B Ramos, RN
• Allen Paule Rara, PT
• Eric Satoshi Redona, PT, DPT
• Shawn Jensen Reed, MD
• Remedy LLC
• Renal Services of America Fhphc Dialysis. LLC (Fresenius Kidney Care FHP Hemodialyisis Center)
• Renal Services of America North Pacific, LLC (Fresenius Kidney Care North Pacific)

• Dental Clinic/Center in Tamuning, GU
• Providers in Tamuning, GU by specialty
• Dental Clinic/Center in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.

Verify at the official NPI Registry.