Individual provider Active NPI

Robert Bonser, DMD

  • Dentist
  • St Petersburg, FL
National Provider Identifier
1043703341
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN23314 Issued in FL
Practice address
4850 1St Ave N
St Petersburg, FL 33713-8108
Phone
(813) 336-8478
NPI assigned
Jun 11, 2018
Last updated
Jul 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23314 FL Primary

Addresses

Primary practice location

4850 1St Ave N
St Petersburg, FL 33713-8108

Mailing address

201 4TH St S Unit 408
Saint Petersburg, FL 33701-4290
Phone (813) 777-3031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200609000918 FL Order and Referring Only - DentistPractitioner - Dentist 4880015320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23314FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist CurrentSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist PastSince May 1, 2020 Accepting new patients

Locations

6882 Gulfport Blvd S
South Pasadena, FL 33707
Phone (727) 384-9655

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1043703341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 4TH ST S UNIT 408",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014290",
            "telephone_number": "813-777-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138108",
            "telephone_number": "813-336-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONSER",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.