Kleber Cortes Bonifacio

Primary specialty

DentistTaxonomy code 122300000X

License

016.0134471 Issued in VT

Practice address

75 Talcott Rd Ste 60
Williston, VT 05495-8122

Phone

(802) 878-9888

NPI assigned

Sep 21, 2026

Last updated

Oct 14, 2026By 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

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1255243721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 WATER SPRING BLVD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347871891",
            "telephone_number": "407-842-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 TALCOTT RD STE 60",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054958122",
            "telephone_number": "802-878-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIFACIO",
        "first_name": "KLEBER",
        "middle_name": "CORTES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0134471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.