Diego Bonilla, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30022 Issued in TX

Practice address

5202 Texana Dr Apt 536
San Antonio, TX 78249-3793

Phone

(817) 937-1411

NPI assigned

Jun 18, 2014

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1275947228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 TEXANA DR APT 536",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493793",
            "telephone_number": "817-937-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 TEXANA DR APT 536",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493793",
            "telephone_number": "817-937-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "DIEGO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luisa Fernanda Bonilla Hernandez, MD
• Carolina Bonilla Jacome, MD
• Jorge Luis Bonilla Velez, DC
• Glenda Lee Bonilla-Santos
• Corina Alyssa Bonilla, OD
• Esther Laura Bonilla, D.D.S
• Javier Bonilla
• Jorge Alberto Bonilla, M.D.
• Jose Arturo Bonilla, M.D.
• Joseph Bonilla, PHD, RD

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.