Active NPI
Javier E Bonilla, DDS
- Dentist
- Weston, FL
National Provider Identifier
1457521312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 17089
- Practice address
- 17140 Royal Palm Blvd
Suite 2
Weston, FL 33326-2312 - Phone
- (954) 217-8411
- Fax
- (951) 217-9243
- NPI assigned
- Mar 6, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN 17089 | FL | Primary |
Addresses
Primary practice location
17140 Royal Palm Blvd
Suite 2
Weston, FL 33326-2312
Mailing address
17140 Royal Palm Blvd
Suite 2
Weston, FL 33326-2312
Phone (954) 217-8411
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN 17089 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1457521312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17140 ROYAL PALM BLVD",
"address_2": "SUITE 2",
"city": "WESTON",
"state": "FL",
"postal_code": "333262312",
"telephone_number": "954-217-8411",
"fax_number": "951-217-9243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17140 ROYAL PALM BLVD",
"address_2": "SUITE 2",
"city": "WESTON",
"state": "FL",
"postal_code": "333262312",
"telephone_number": "954-217-8411",
"fax_number": "951-217-9243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONILLA",
"first_name": "JAVIER",
"middle_name": "E",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-06",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 17089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.