Individual provider Active NPI

Robin Elaine Bonnell, D.M.D.

  • Dentist
  • Barbourville, KY
National Provider Identifier
1518189679
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8692 Issued in KY
Practice address
16 Windburn Dr
Barbourville, KY 40906-7843
Phone
(606) 261-7309
NPI assigned
May 2, 2007
Last updated
Jun 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8692 KY Primary
General Practice Dentistry 1223G0001X 0401410153 VA

Addresses

Primary practice location

16 Windburn Dr
Barbourville, KY 40906-7843

Mailing address

1004 Pinella Dr
Corbin, KY 40701-8763
Phone (606) 261-7309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20221027002177 KY Practitioner - Dentist 1658748082 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8692KYMDDentist
0401410153VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dayspring Health, Inc. CurrentSince Sep 8, 2022 Accepting new patients
Dayspring Health Inc Dentist CurrentSince Sep 8, 2022 Accepting new patients
Dayspring Health Inc Current Accepting new patients

Locations

402 Cumberland Ave
Williamsburg, KY 40769
Phone (423) 784-5771

640 W Highway 92
Ste 3
Williamsburg, KY 40769
Phone (606) 549-0464

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1518189679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 PINELLA DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018763",
            "telephone_number": "606-261-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WINDBURN DR",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409067843",
            "telephone_number": "606-261-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNELL",
        "first_name": "ROBIN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8692",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.