Thomas Carleton Bordieri, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11421 Issued in OR

Practice address

2137 NE 4TH St
Bend, OR 97701-3824

Phone

(541) 389-4807

NPI assigned

Apr 29, 2019

Last updated

Jun 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elcik and Bordieri, LLC

  dba Red Rock Dental Group

  • Dental Clinic/Center
  • Redmond, OR
  • NPI 1093568354
  NPD Authorized official
• Skyline Dental LLC

  • General Practice Dentistry
  • Bend, OR
  • NPI 1093440208
  NPD
• Zack Porter D.D.S. PC

  dba Skyline Dental

  • Dentist
  • Bend, OR
  • NPI 1760863096
  NPD (past)

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1487218095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 NE 4TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013824",
            "telephone_number": "541-389-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 NE 4TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013824",
            "telephone_number": "541-389-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDIERI",
        "first_name": "THOMAS",
        "middle_name": "CARLETON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Nicholas Boragno
• Harry Richard Borcherding II, PMHNP
• Douglas Grant Bordan, P.T.
• Amy Kathryn Bordelon, LMFT
• Peter Bordelon, PMHNP
• Brooke Borgognoni
• Melvin Bornstein, D.C
• Borsting LLC
• Emily Borsting, M.D.
• Brooke Kathleen Boskovich, RD

• General Practice Dentistry in Bend, OR
• Providers in Bend, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.