Christina Bonaventura, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

054960 Issued in NY

Practice address

800 Woodbury Rd
Suite J
Woodbury, NY 11797-2503

Phone

(516) 364-3388

NPI assigned

Jul 20, 2010

Last updated

Jun 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1528371465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TAFT DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873128",
            "telephone_number": "516-672-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WOODBURY RD",
            "address_2": "SUITE J",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972503",
            "telephone_number": "516-364-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAVENTURA",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054960",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raja Shekhar Bikumandla, PHYSICAL THERAPIST
• Laurence G Bilsky, MD
• Robin Black
• Karla Annette Blakes, M.D.
• Gary Richard Blank, D.P.M.
• William J Breen, MD
• Carly Brod, M.S.ED
• Heather Broderick
• Judith T Brook, M.D.,
• Emily S Brooks, M.D.

• General Practice Dentistry in Woodbury, NY
• Providers in Woodbury, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.