Jeremiah Bondra, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS036218 Issued in PA

Practice address

214 W Grandview Ave
Zelienople, PA 16063-1137

Phone

(724) 452-7960

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1346334372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W GRANDVIEW AVE",
            "city": "ZELIENOPLE",
            "state": "PA",
            "postal_code": "160631137",
            "telephone_number": "724-452-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W GRANDVIEW AVE",
            "city": "ZELIENOPLE",
            "state": "PA",
            "postal_code": "160631137",
            "telephone_number": "724-452-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDRA",
        "first_name": "JEREMIAH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036218",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.022253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Nicole Beyale
• Lisa Bills, MSW LSW
• Renee Marie Blough, RPH.
• Lindsay Boehler
• Erica Beth Boltz, MS
• Jeffrey James Borandi, DMD
• Emily Rose Boudreaux, MA, NCC, LPC
• Kaitlyn R Brazauskas, MS, CCC-SLP
• Rebecca Bream
• Lisa A Brink, LPC

• All providers in Zelienople, PA
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.