Jonar R Bonifacio, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

47454 Issued in CA

Practice address

1620 Alpine Blvd
#121
Alpine, CA 91901-1102

Phone

(619) 445-8896

Fax

(619) 445-7339

NPI assigned

Jul 28, 2006

Last updated

Apr 26, 2017By the provider in NPPES

Sex

Male

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 CA

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

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.

• Jonar R Bonifacio, DDS, Inc

  dba Alpine Dentistry

  • General Practice Dentistry
  • Alpine, CA
  • NPI 1790515484
  NPD Authorized official
• Alpine Dentistry

  • Dentist
  • Alpine, CA
  • NPI 1578716148
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1164436705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 ALPINE BLVD",
            "address_2": "#121",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011102",
            "telephone_number": "619-445-8896",
            "fax_number": "619-445-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ALPINE BLVD",
            "address_2": "#121",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011102",
            "telephone_number": "619-445-8896",
            "fax_number": "619-445-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIFACIO",
        "first_name": "JONAR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan A. Benich, MSPT
• Nayeli Bensor-Dominguez
• William Sidney Blackmore, D.M.D.
• Joshua Matthew Blessing, M.D.
• Bold Plate Nutrition, LLC
• Jennifer Boules-Syta
• Cybill Bowens-Vargas
• Linda A Branch, RDA
• Marie Bridgeford
• Abigail Kate Brown

• Dentist in Alpine, CA
• Providers in Alpine, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.