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Deactivated NPI 1811199540 Deactivated / Inactive NPI Male Practitioner

Dr. Boulos F Maksemous , DDS

Dentist - General Practice • Fontana, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Boulos Maksemous has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 04, 2007
NPI Deactivation Date January 24, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Boulos Maksemous, DDS was a registered Dentist - General Practice practicing in Fontana, CA. Throughout an active medical career spanning 17 years, Dr. Maksemous provided care at the practice location at 18035 MONTGOMERY AVE until profile deactivation on 2024-01-24.

Practice Location & Contact Primary Location

Practice Address

18035 Montgomery Ave

Fontana, CA 923362377

Telephone 9096413424

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fontana, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
65 Specialists

Practicing in Fontana, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA DL032125

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 24, 2024

Record deactivated on January 24, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 18035 MONTGOMERY AVE, FONTANA, CA 923362377 (Tel: 9096413424)

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Updated Business Mailing Address July 08, 2007

Registered at 18035 MONTGOMERY AVE, FONTANA, CA 923362377 (Tel: 9096413424)

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Provider Name / Credentials Updated July 08, 2007

Recorded as BOULOS MAKSEMOUS, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #DL032125 in CA)

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Initial NPI Registration & Enumeration June 04, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1811199540
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 04, 2007
Last Update: July 08, 2007
Deactivation Date: January 24, 2024

Mailing Address

18035 Montgomery Ave

Fontana, CA 923362377

Phone: 9096413424

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.