Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shadi Boutros, DDS

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1457489239

Dr. Shadi Boutros, DDS is an Oral Surgery in Martinez, California. Graduated from University of Southern California Keck School of Medicine in 2011, 15 years ago. Licensed in California.

Years since qualifying
15
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2007
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

2500 Alhambra Ave
Martinez, CA 94553-3156
Phone: (925) 370-5200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 54887 (CA)

Record details

NPI number1457489239
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMarch 1, 2007
Last updated in NPPESMay 13, 2015
Mailing address2500 Alhambra Ave, Martinez, CA 94553-3156

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare