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BOUSTANI PERIODONTICS PC
NPI 1114745155
Dentist - Periodontics in Providence, RI

Active since September 30, 2024
40 ELMGROVE AVE, PROVIDENCE, RI 02906(401) 421-1717(401) 421-0066 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Boustani Periodontics Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOUSTANI PERIODONTICS PC (NPI 1114745155) is a healthcare organization registered as a periodontics in Providence, Rhode Island and active in the NPI registry since September 2024. The organization lists Gabriel Boustani, President, as its authorized official.

NPPES Registry Identity

NPI1114745155
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameBOUSTANI PERIODONTICS PC
Location Address40 ELMGROVE AVEProvidence, RI 02906-4104
Mailing Address40 Elmgrove AveProvidence, RI 02906-4104 · (401) 421-1717 · Fax (401) 421-0066
Phone(401) 421-1717
Fax(401) 421-0066
Organization SubpartNo
Authorized OfficialGabriel BoustaniPresident · (617) 640-4637
Enumeration DateSeptember 30, 2024
NPPES CertifiedSeptember 30, 2024
✔ NPI 1114745155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
40 ELMGROVE AVE, Providence, RI 02906
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boustani Periodontics PC's NPI number?

The NPI number for Boustani Periodontics PC is 1114745155. It was assigned to this organization in the NPPES registry on September 30, 2024.

Where is Boustani Periodontics PC located?

Boustani Periodontics PC is located at 40 Elmgrove Ave, Providence, RI 02906. The listed phone number is (401) 421-1717.

What is Boustani Periodontics PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Boustani Periodontics PC was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.