Individual provider Active NPI

Isabel Ulerio-Bonilla, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1346338712
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
045323 Issued in NY
Practice address
577 Isham St
Suite 1-G
New York, NY 10034-2034
Phone
(212) 942-9900
Fax
(212) 942-2388
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 045323 NY Primary
Dentist 122300000X 22D102072400 NJ

Addresses

Primary practice location

577 Isham St
Suite 1-G
New York, NY 10034-2034

Mailing address

577 Isham St
Suite 1-G
New York, NY 10034-2034
Phone (212) 942-9900

Other identifiers 1

IdentifierTypeStateIssuer
01510269MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22D102072400NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1346338712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 ISHAM ST",
            "address_2": "SUITE 1-G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100342034",
            "telephone_number": "212-942-9900",
            "fax_number": "212-942-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 ISHAM ST",
            "address_2": "SUITE 1-G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100342034",
            "telephone_number": "212-942-9900",
            "fax_number": "212-942-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULERIO-BONILLA",
        "first_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045323",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102072400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01510269",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.