Peter Stephen Bonifatto, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

101732 Issued in CA

Practice address

24218 Valencia Blvd
Valencia, CA 91355-5391

Phone

(661) 288-0288

Fax

(661) 286-9925

NPI assigned

Aug 14, 2017

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nea Dentistry LLC

  • Dentist
  • Las Vegas, NV
  • NPI 1629573266
  NPD Authorized official
• Elie Professional Dental Corporation

  • General Practice Dentistry
  • Valencia, CA
  • NPI 1215022165
  NPD (past)
• Soleiman Professional Dental Corporation

  • Periodontics
  • Valencia, CA
  • NPI 1437364288
  NPD (past)
• Terri Nguyen Dental Corporation

  • Periodontics
  • Santa Clarita, CA
  • NPI 1649361478

  General Practice

  NPD (past)

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235655010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 HANCOCK AVE APT 14",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900696804",
            "telephone_number": "702-588-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24218 VALENCIA BLVD",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555391",
            "telephone_number": "661-288-0288",
            "fax_number": "661-286-9925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26877 Sierra Hwy",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913212274",
            "country_code": "US",
            "telephone_number": "661-251-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONIFATTO",
        "first_name": "PETER",
        "middle_name": "STEPHEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey Marie Bogoje, M.A., LMFT
• Jamie Bolosky
• Fariba Bolourchi, DDS
• Brigitte Pauline Bonchay, LCSW
• Paul Bong, MD
• Gabriela Bonilla
• Rylee Addison Booth
• Leisha Borja, LMFT
• Wendy Boschma, M.A. CCC/SLP
• Boston Scientific Neuromodulation Corporation

• General Practice Dentistry in Valencia, CA
• Providers in Valencia, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.