NPIMap

Organization Active NPI

Gary W Bardonner, DDS, Inc

  • General Practice Dentistry
  • Greenfield, IN
National Provider Identifier
1285768259
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007317 Issued in IN
Legal business name
GARY W BARDONNER, DDS, INC
Practice address
940 N State St
Greenfield, IN 46140-1202
Phone
(317) 462-2656
NPI assigned
Mar 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gary W Bardonner, D.D.S.NPI 1720270374
Title
President
Phone
(317) 462-2656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 12007317 IN Primary

Addresses

Primary practice location

940 N State St
Greenfield, IN 46140-1202

Mailing address

940 N State St
Greenfield, IN 46140-1202
Phone (317) 462-2656

Other identifiers 2

IdentifierTypeStateIssuer
12009221OtherINSTATE DENTAL LICENSE
12007317OtherINSTATE DENTAL LICENSE

National Provider Directory

National Provider Directory

Locations

940 N State St
Greenfield, IN 46140
Phone (317) 462-2656

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285768259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 N STATE ST",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401202",
            "telephone_number": "317-462-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 N STATE ST",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401202",
            "telephone_number": "317-462-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY W BARDONNER, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARDONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-462-2656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "12009221",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "12007317",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.