Active NPI
David R Bonnevie, DDS
- Dentist
- Niagara Falls, NY
National Provider Identifier
1073773495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 035042
- Practice address
- 2145 Lancelot Dr
Niagara Falls, NY 14304-3093 - Phone
- (716) 297-1644
- Fax
- (716) 297-9855
- NPI assigned
- Jun 10, 2008
- Last updated
- Jun 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 035042 | NY | Primary |
Addresses
Primary practice location
2145 Lancelot Dr
Niagara Falls, NY 14304-3093
Mailing address
2145 Lancelot Dr
Niagara Falls, NY 14304-3093
Phone (716) 297-1644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00644380 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Dental of Niagara | Past | Accepting new patients | |
| Dental Care Associates | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Niagara Falls, NY
- NPI 1780649244
-
- General Practice Dentistry
- Niagara Falls, NY
- NPI 1659336113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1073773495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2145 LANCELOT DR",
"city": "NIAGARA FALLS",
"state": "NY",
"postal_code": "143043093",
"telephone_number": "716-297-1644",
"fax_number": "716-297-9855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2145 LANCELOT DR",
"city": "NIAGARA FALLS",
"state": "NY",
"postal_code": "143043093",
"telephone_number": "716-297-1644",
"fax_number": "716-297-9855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNEVIE",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "035042",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00644380",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Niagara Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.