Bryan E Bonnet DDS PC Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRYAN E BONNET DDS PC INC

Practice address

12195 S Yukon Ave
Glenpool, OK 74033-6621

Phone

(918) 322-9445

NPI assigned

Oct 19, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Bryan E Bonnet, DDSNPI 1144217985

Title

Owner/Dentist

Phone

(918) 322-6445

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Bryan Edward Bonnet, DDS

  • General Practice Dentistry
  • Glenpool, OK
  • NPI 1144217985
  NPD Authorized official

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1356067474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12195 S YUKON AVE",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740336621",
            "telephone_number": "918-322-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12195 S YUKON AVE",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740336621",
            "telephone_number": "918-322-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN E BONNET DDS PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "BONNET",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "918-322-6445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100255520A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Rourke Biddick, D.C.
• Bliss Family Medicine PLLC
• Theron Joseph Bliss, DO
• Jennifer Block
• Bryan Edward Bonnet, DDS
• Raven Burke
• Janice Burkybile, DNP, APRN-CNP
• Barbara Byrd, COTA
• Calm Tomorrows LLC
• Christinne Melody Caylan-Linstromberg, RD

• All providers in Glenpool, OK
• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.