Bryan Edward Bonnet, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5456 Issued in OK

Practice address

12195 S Yukon Ave
Glenpool, OK 74033-6621

Phone

(918) 322-9445

NPI assigned

Oct 5, 2005

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bryan E Bonnet DDS PC Inc

  • Dental Clinic/Center
  • Glenpool, OK
  • NPI 1356067474
  NPD Authorized official

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1144217985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12195 S YUKON AVE",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740336621",
            "telephone_number": "918-322-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12195 S YUKON AVE",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740336621",
            "telephone_number": "918-322-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNET",
        "first_name": "BRYAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5456",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Bertram, RN
• Ryan Rourke Biddick, D.C.
• Bliss Family Medicine PLLC
• Theron Joseph Bliss, DO
• Jennifer Block
• Bryan E Bonnet DDS PC Inc
• Raven Burke
• Janice Burkybile, DNP, APRN-CNP
• Barbara Byrd, COTA
• Calm Tomorrows LLC

• General Practice Dentistry in Glenpool, OK
• Providers in Glenpool, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.