Individual provider Active NPI

Bonita Ann Wynkoop, D.D.S.

  • General Practice Dentistry
  • Nassau Bay, TX
National Provider Identifier
1265429286
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16947 Issued in TX
Practice address
2200 Space Park Dr
#300
Nassau Bay, TX 77058-3677
Phone
(281) 333-3406
Fax
(281) 333-3442
NPI assigned
Oct 4, 2005
Sex
Female
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 16947 TX Primary

Addresses

Primary practice location

2200 Space Park Dr
#300
Nassau Bay, TX 77058-3677

Mailing address

2200 Space Park Dr
#300
Nassau Bay, TX 77058-3677
Phone (281) 333-3406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160511001656 FL Order and Referring Only - DentistPractitioner - Dentist 0345539565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16947TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sonya G. Morgan, D.D.S., Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265429286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SPACE PARK DR",
            "address_2": "#300",
            "city": "NASSAU BAY",
            "state": "TX",
            "postal_code": "770583677",
            "telephone_number": "281-333-3406",
            "fax_number": "281-333-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SPACE PARK DR",
            "address_2": "#300",
            "city": "NASSAU BAY",
            "state": "TX",
            "postal_code": "770583677",
            "telephone_number": "281-333-3406",
            "fax_number": "281-333-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNKOOP",
        "first_name": "BONITA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nassau Bay, TX

Sources for this page

Verify at the official NPI Registry.