Active NPI
Bonnie Rae, DMD
- General Practice Dentistry
- Delray Beach, FL
National Provider Identifier
1528239076
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Nov 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17478
- Practice address
- 4665 W Atlantic Ave
Delray Beach, FL 33445-3800 - Phone
- (561) 498-0050
- NPI assigned
- Mar 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17478 | FL | Primary |
Addresses
Primary practice location
4665 W Atlantic Ave
Delray Beach, FL 33445-3800
Mailing address
4665 W Atlantic Ave
Delray Beach, FL 33445-3800
Phone (561) 498-0050
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17478 | FL | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205280000000",
"number": "1528239076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4665 W ATLANTIC AVE",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334453800",
"telephone_number": "561-498-0050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4665 W ATLANTIC AVE",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334453800",
"telephone_number": "561-498-0050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAE",
"first_name": "BONNIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-12",
"last_updated": "2008-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "17478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delray Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.