Active NPI
Amber-Lee Hester Bonanni, RDH
- Dental Hygienist
- Fort Stewart, GA
National Provider Identifier
1609503986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH043969
- Practice address
- 2115 Gulick Ave
Fort Stewart, GA 31314 - Phone
- (609) 742-5079
- NPI assigned
- Aug 5, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH043969 | GA | Primary |
Addresses
Primary practice location
2115 Gulick Ave
Fort Stewart, GA 31314
Mailing address
15 Bark Branch Rd
Richmond Hill, GA 31324-6900
Phone (609) 742-5079
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 |
|---|---|---|---|
| DH043969 | GA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1609503986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 BARK BRANCH RD",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313246900",
"telephone_number": "609-742-5079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 GULICK AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314",
"telephone_number": "609-742-5079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONANNI",
"first_name": "AMBER-LEE",
"middle_name": "HESTER",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-05",
"last_updated": "2022-08-05",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "GA",
"license": "DH043969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.