Scott C. Bonin, DDS

Individual provider Active NPI General Practice Dentistry · Windsor, CA

NPI 1154513083 · NPPES record last updated Jul 22, 2022

Key facts

NPI
1154513083
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
49845 (CA)
Practice address
100 Windsor River Rd
Windsor, CA 95492-9204
Phone
(707) 838-1400
Fax
(707) 838-1489
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
49845CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott C. Bonin D.D.S. a Professional Denal Corporation General Practice Current
since Jul 24, 2022
Accepting new patients
Luke F Landeros, DDS, PC General Practice Past Accepting new patients

Locations

100 Windsor River Rd
Windsor, CA 95492
Phone (707) 838-1400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 49845 CA Yes

Addresses

Primary practice location

100 Windsor River Rd
Windsor, CA 95492-9204

Mailing address

100 Windsor River Rd
Windsor, CA 95492-9204
Phone (707) 838-1400

Other providers in Windsor, CA

All providers in Windsor, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.