Fredric L Bonine, DDS, MS, PC

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

2910112106 Issued in MI

Practice address

6893 Grand River Rd
Brighton, MI 48114-9345

Phone

(810) 229-9180

Fax

(810) 229-1880

NPI assigned

Jun 30, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

• Fredric L. Bonine, DDS, Ms, PC

  • Preferred Provider Organization
  • Brighton, MI
  • NPI 1184980914
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1063440543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6893 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149345",
            "telephone_number": "810-229-9180",
            "fax_number": "810-229-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6893 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149345",
            "telephone_number": "810-229-9180",
            "fax_number": "810-229-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONINE",
        "first_name": "FREDRIC",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MI",
            "license": "2910112106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOLE PROPRIETOR NPI",
            "identifier": "1184980914",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Boggs, RBT
• Kevin John Bohnsack, M.D.
• Melanie Bondoc, MD
• Kira Boneff, MS
• James Vincent Bonifer
• Joseph Bono, PH.D., P.C.
• Jeffrey Robert Borgeson, MD
• Addison Borlace
• Lisa Marie Boschma, LMSW
• Nicole Lynn Boucher, CPNP-PC

• Oral and Maxillofacial Pathology Dentistry in Brighton, MI
• Providers in Brighton, MI by specialty
• Oral and Maxillofacial Pathology Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.