Tammy L Bonenfant
Individual provider Active NPI Dental Hygienist · Nipomo, CA
NPI 1023034162 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023034162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- RDH 18476 (CA)
- Practice address
- 150 Tejas PL
Nipomo, CA 93444-9123 - Phone
- (805) 938-0935
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RDH 18476 | CA | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | RDH 18476 | CA | Yes |
Addresses
Primary practice location
150 Tejas PL
Nipomo, CA 93444-9123
Mailing address
150 Tejas PL
Nipomo, CA 93444-9123
Phone (805) 938-0935
Other providers in Nipomo, CA
- Ben Palmer, O.D. a Professional Optometric Corporation
- Brian N Beres
- Natalia A Berryman
- Beyond Behavior Consulting
- Sabrina Blankenship
- Jennifer Bonino
- Kassandra Boortz
- Kenton Bosch
- Kari Marie Bowron
- Elisabeth C Box
All providers in Nipomo, CA · Dental Hygienist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.