Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1427636273 Individual Practitioner Female Practitioner

Dr. Petra Nihad Boutros , DMD

Dentist • Columbus, OH

Professional Overview & Biography Verified Profile Summary

Dr. Petra Boutros, DMD is a registered healthcare professional specializing in Dentist in Columbus, OH. Practice services are available at 305 W 12TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

305 W 12th Ave

Columbus, OH 432101267

Telephone 6146883763
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Columbus, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 18.4 Yrs
Regional Practice Density
317 Specialists

Practicing in Columbus, OH (2953 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

CMS Verified: 2022-05-18
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OH RES.004349

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

5370 Birkdale St Nw

Canton, OH 447081872

Phone: 3303169731

Practice Associates & Co-Workers

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

38 Associated Practitioners
Olivia Bartholomew

Student in an Organized Health Care Education/Training Program

NPI 1083406987
Dr. Cristobal Urrutia , DDS

Dentist - General Practice

NPI 1124695358

Doctor of Dental Surgery

Dr. Kalia Theodorou , DDS

Dentist - Periodontics

NPI 1144882242

Doctor of Dental Surgery

Yu-Chang Wu

Dentist - Periodontics

NPI 1184399149
NPI 1235668732

Doctor of Dental Surgery

Isa Rodriguez

Dentist - General Practice

NPI 1245930544

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location May 18, 2022

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267 (Tel: 6146883763)

📍
Updated Business Mailing Address May 18, 2022

Registered at 305 W 12TH AVE, COLUMBUS, OH 432101267

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2022

Student in an Organized Health Care Education/Training Program

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 16, 2021

Dentist (License #RES.004349 in OH)

NPI Profile Active April 01, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location April 01, 2021

Registered at 5370 BIRKDALE ST NW, CANTON, OH 447081872 (Tel: 3303169731)

📍
Updated Business Mailing Address April 01, 2021

Registered at 5370 BIRKDALE ST NW, CANTON, OH 447081872

👤
Provider Name / Credentials Updated April 01, 2021

Recorded as PETRA BOUTROS, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 01, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 01, 2021

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: 1427636273
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 01, 2021
Last Update: May 18, 2022
Sole Proprietor: No

Mailing Address

305 W 12th Ave

Columbus, OH 432101267

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.