Fredric L. Bonine, DDS, Ms, PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

2901012106 Issued in MI

Legal business name

FREDRIC L. BONINE, DDS, MS, PC

Practice address

6893 Grand River Rd
Brighton, MI 48114-9345

Phone

(810) 229-9180

Fax

(810) 229-1880

NPI assigned

Apr 5, 2012

Organization subpart

Yes

Parent organization

DR. FREDRIC L. BONINE, DDS, MS, PCAs reported in NPPES

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

Authorized official

Name

Dr. Fredric L. Bonine, DDS, MS, PCNPI 1063440543

Title

Sole Proprietor

Phone

(810) 229-9180

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fredric L. Bonine, DDS, MS, PC Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Part of

Fredric L Bonine DDS Ms PC

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fredric L Bonine, DDS, MS, PC

  • Oral and Maxillofacial Pathology Dentistry
  • Brighton, MI
  • NPI 1063440543
  Medicare reassignment Authorized official
• Gary Anthony Forgach, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Bloomfield Hills, MI
  • NPI 1639411747
  NPD

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1184980914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6893 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149345",
            "telephone_number": "810-229-9180",
            "fax_number": "810-229-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6893 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149345",
            "telephone_number": "810-229-9180",
            "fax_number": "810-229-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDRIC L. BONINE, DDS, MS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR. FREDRIC L. BONINE, DDS, MS, PC",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "BONINE",
        "authorized_official_first_name": "FREDRIC",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "810-229-9180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS, PC"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MI",
            "license": "2901012106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1063440543",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fredric L. Bonine, DDS, MS, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Ellen Fortson, MSW, LCSW
• Ashley Fowler
• Mark Charles Francuck, D.D.S.
• Dana Frank
• Sarah Nicole Frank
• Tara Marie Freni, LLMFT, LLPC
• Joseph Daniel Friedli, MD
• Evan Fry, PA-C
• John Douglas Furey, LMSW
• Emily Jean Gabbeart, M.D.

• Preferred Provider Organization in Brighton, MI
• Providers in Brighton, MI by specialty
• Preferred Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.