Tara Marie Bonneau, RDH, BS, MBA

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

002024691 Issued in CO

Practice address

1752 28TH Ave
Greeley, CO 80634-5715

Phone

(303) 808-7722

NPI assigned

Apr 19, 2024

Sex

Female

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

Enrolled in CO

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

Bachelor of Science, Master of Business Administration

State licenses

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1124873443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 28TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345715",
            "telephone_number": "303-808-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 28TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345715",
            "telephone_number": "303-808-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEAU",
        "first_name": "TARA MARIE",
        "credential": "RDH, BS, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "002024691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Bond, RPH
• Katherine Bond, O.D.
• Meghan Kathleen Bonde, M.A. CCC-SLP
• Bonding and Behavior, LLC
• Nicole Bondy, RN
• Adam Elbert Bonner, PA
• Kristie Lynette Border, LMT
• Jason Boren, PA
• John Herbert Borkert, M.D.
• Lauren Alice Borkowski

• Dental Hygienist in Greeley, CO
• Providers in Greeley, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.