Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1568869501 Individual Practitioner Male Practitioner

Ebbie Boutehsaz

Dentist - General Practice • Bronx, NY

Professional Overview & Biography Verified Profile Summary

Ebbie Boutehsaz is a registered healthcare professional specializing in Dentist - General Practice in Bronx, NY. Practice services are available at 3310 BAINBRIDGE AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3310 Bainbridge Ave

Bronx, NY 10467

Telephone 7186543456
Associated Practice Facility / Clinic
🏢 Your Bronx Dentist Facility NPI 1184107344

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bronx, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.2 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
378 Specialists

Practicing in Bronx, NY (8411 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 NY 058225-1

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.

Secondary Practice Locations

760 Broadway, Room 2c-320

Brooklyn, NY 112065317

Phone: 7189638308

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Eileen Wang

Dentist - General Practice

NPI 1225694896
Dr. Alan Spector , DMD

Dentist - General Practice

NPI 1568465565

Doctor of Dental Medicine

Dr. Bibeka Bhattarai Koirala , DMD

Dentist - General Practice

NPI 1649538596

Doctor of Dental Medicine

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location November 14, 2018

Registered at 3310 BAINBRIDGE AVE, BRONX, NY 10467 (Tel: 7186543456)

📍
Updated Business Mailing Address November 14, 2018

Registered at 3310 BAINBRIDGE AVE, BRONX, NY 104672856 (Tel: 7186543456)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2018

Dentist (License #058225-1 in NY)

NPI Profile Active November 19, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location November 19, 2014

Registered at 760 BROADWAY, ROOM 2C-320, BROOKLYN, NY 112065317 (Tel: 7189638308)

📍
Updated Business Mailing Address November 19, 2014

Registered at 760 BROADWAY, ROOM 2C-320, BROOKLYN, NY 112065317 (Tel: 7189638308)

👤
Provider Name / Credentials Updated November 19, 2014

Recorded as EBBIE BOUTEHSAZ

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 19, 2014

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration November 19, 2014

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: 1568869501
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 19, 2014
Last Update: November 14, 2018
Sole Proprietor: No

Mailing Address

3310 Bainbridge Ave

Bronx, NY 104672856

Phone: 7186543456

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.