Dennis Bonavilla

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

34859 Frederick Street
Suite 112
Wildomar, CA 92595

Phone

(951) 897-0770

NPI assigned

Aug 23, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1023535820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34859 FREDERICK ST STE 112",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34859 FREDERICK STREET",
            "address_2": "SUITE 112",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "92595",
            "telephone_number": "951-897-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAVILLA",
        "first_name": "DENNIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Blankenship, RBT
• Blue Pearl Project
• Brooke Bocanegra
• Kayla Bochenek
• Brooklynn Bolden
• Marcella A Bonnici, MD
• Marie Bonovitz, LCSW
• Jennine Marie White Borchert, P.A.-C.
• Gretchen Borgerding
• Lisa M Bornmann, P.A.-C

• Electroneurodiagnostic Specialist/Technologist in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Electroneurodiagnostic Specialist/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.