Amanda Louise Bonn Vesterso

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2037 Issued in ND

Practice address

2810 17TH Ave S
Grand Forks, ND 58201-4010

Phone

(701) 775-0641

Fax

(701) 746-9328

NPI assigned

Jun 23, 2008

Last updated

Jun 23, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Louise Bonn Former name

Medicare fee-for-service enrollment

Enrolled in ND

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

State licenses

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1629239637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 17TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-775-0641",
            "fax_number": "701-746-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 17TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-775-0641",
            "fax_number": "701-746-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESTERSO",
        "first_name": "AMANDA",
        "middle_name": "LOUISE BONN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BONN",
            "middle_name": "LOUISE",
            "credential": "D. D. S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rylee M Venn, DO
• Kristi Ventzke, LMFT
• Jennifer Ann Verkuehlen, FNP-C
• Vertebrae PLLC
• Mallory Vesling, MD
• Veteran Home Care LLC
• Bryn Vettleson
• Rebecca Anne Vigen, MS, APRN, NP-C
• Marybeth Vigness
• Michael Villas, PHYSICIAN ASSISTANT

• General Practice Dentistry in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.