NPIMap

Organization Active NPI

Michael Bonomo, DMD, LLC

  • Public Health Dentistry
  • Red Hill, PA
National Provider Identifier
1295073914
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DS028191L Issued in PA
Legal business name
MICHAEL BONOMO, DMD, LLC
Practice address
942 Main St
Red Hill, PA 18076-1339
Phone
(215) 679-8033
NPI assigned
Jan 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Authorized official

Name
Dr. Michael A. Bonomo, DMD
Title
Owner
Phone
(215) 679-8033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0001X DS028191L PA Primary

Addresses

Primary practice location

942 Main St
Red Hill, PA 18076-1339

Mailing address

942 Main St
Red Hill, PA 18076-1339
Phone (215) 679-8033

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1295073914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 MAIN ST",
            "city": "RED HILL",
            "state": "PA",
            "postal_code": "180761339",
            "telephone_number": "215-679-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 MAIN ST",
            "city": "RED HILL",
            "state": "PA",
            "postal_code": "180761339",
            "telephone_number": "215-679-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BONOMO, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "BONOMO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-679-8033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "PA",
            "license": "DS028191L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.