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DR. CARLY RACHELLE BOUDREAUX DMD
NPI 1326604497
Dentist - Pediatric Dentistry in Washington, MO

Active since May 14, 2019PECOS Enrolled
1709 HERITAGE HILLS DR, WASHINGTON, MO 63090(636) 238-3520 Get Directions Write a Review

NPPES record last updated: August 5, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 5, 2021, May 14, 2019 (2 updates tracked since 2019).

About Dr. Carly Rachelle Boudreaux Dmd NPPES

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

DR. CARLY RACHELLE BOUDREAUX DMD (NPI 1326604497) is an individual pediatric dentistry provider in Washington, Missouri, licensed in Missouri (2021024201) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326604497
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameDR. CARLY RACHELLE BOUDREAUXCredential: DMD
Location Address1709 HERITAGE HILLS DRWashington, MO 63090-4621
Mailing Address114 Metals DrYoungsville, LA 70592-5812 · (337) 654-6866
Phone(636) 238-3520
Sole ProprietorNo
Enumeration DateMay 14, 2019
Last NPPES UpdateAugust 5, 20212 updates tracked since enumeration
NPPES CertifiedAugust 5, 2021
✔ NPI 1326604497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MO · 2021024201
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1709 HERITAGE HILLS DR, Washington, MO 63090
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Carly Rachelle Boudreaux Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63090 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

C. HASTINGS, DDS, LLC
Clinic/Center (Dental)
1709 HERITAGE HILLS DR
WASHINGTON, MO 63090
Franklin County (314) 496-3562

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 Carly Boudreaux's NPI number?

The NPI number for Carly Boudreaux is 1326604497. It was assigned to this individual provider in the NPPES registry on May 14, 2019.

Where is Carly Boudreaux located?

Carly Boudreaux practices at 1709 Heritage Hills Dr, Washington, MO 63090. The listed phone number is (636) 238-3520.

What is Carly Boudreaux's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Carly Boudreaux enrolled in Medicare?

Yes. Carly Boudreaux is registered in the Medicare PECOS enrollment system.

What insurance does Carly Boudreaux accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Guardian and Humana and 1 other insurer list Carly Boudreaux as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carly Boudreaux was last updated on August 5, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.