Kenneth L Bonnette, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3658 Issued in LA

Practice address

4700 Shreveport Blanchard Hwy
Shreveport, LA 71107-4702

Phone

(318) 221-1001

Fax

(318) 221-1044

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCEECD/Endpoint/CCEECD

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.

• WK Community Health Clinic

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1558393371

  Dentist

  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053349571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SHREVEPORT BLANCHARD HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711074702",
            "telephone_number": "318-221-1001",
            "fax_number": "318-221-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SHREVEPORT BLANCHARD HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711074702",
            "telephone_number": "318-221-1001",
            "fax_number": "318-221-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNETTE",
        "first_name": "KENNETH",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "3658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1836583",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonne Fete Maternity
• Erica Bonner
• Francine Bonner
• Latonia Bonnett
• Brynner L Bonnette, DDS
• Bonnie's Express Transportation
• Robert Layne Bonvillain, LCSW, LAC
• Keisha Roichelle Bonyfield, APRN
• Boogey Make-Up Studio Hair Loss Specialist
• Booker SCC LLC (SCC of Booker T. Washington Rehabilitation Center)

• Dentist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.