Organization Active NPI

Raymond Bonomo Periodontics

  • Periodontics
  • Cincinnati, OH
National Provider Identifier
1144595901
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
021449 Issued in OH
Legal business name
RAYMOND BONOMO PERIODONTICS
Practice address
424 Ray Norrish Dr
Cincinnati, OH 45246-1520
Phone
(513) 671-0222
Fax
(513) 671-0256
NPI assigned
Mar 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Dr. Raymond Bonomo, D.M.D
Title
Owner
Phone
(513) 671-0222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 021449 OH Primary

Addresses

Primary practice location

424 Ray Norrish Dr
Cincinnati, OH 45246-1520

Mailing address

34 Remick Blvd
Springboro, OH 45066-9168
Phone (937) 886-9940

Other identifiers 1

IdentifierTypeStateIssuer
1588715726OtherOHNPI #

National Provider Directory

National Provider Directory

Locations

34 Remick Blvd
Springboro, OH 45066

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1144595901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 REMICK BLVD",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669168",
            "telephone_number": "937-886-9940",
            "fax_number": "937-886-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 RAY NORRISH DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452461520",
            "telephone_number": "513-671-0222",
            "fax_number": "513-671-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND BONOMO PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "BONOMO",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-671-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "021449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1588715726",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.