Individual provider Active NPI

Frank Thomas Bordonaro, D.D.S.

  • General Practice Dentistry
  • Victorville, CA
National Provider Identifier
1205838356
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30333 Issued in CA
Practice address
15247 11TH St
Ste 300
Victorville, CA 92395-3727
Phone
(760) 245-1049
Fax
(760) 245-5501
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30333 CA Primary

Addresses

Primary practice location

15247 11TH St
Ste 300
Victorville, CA 92395-3727

Mailing address

15247 11TH St
Ste 300
Victorville, CA 92395-3727
Phone (760) 245-1049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150422002317 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870811896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30333CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205838356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15247 11TH ST",
            "address_2": "STE 300",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953727",
            "telephone_number": "760-245-1049",
            "fax_number": "760-245-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15247 11TH ST",
            "address_2": "STE 300",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953727",
            "telephone_number": "760-245-1049",
            "fax_number": "760-245-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDONARO",
        "first_name": "FRANK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.