Individual provider Active NPI

Robert Paul Bonness, DDS

  • General Practice Dentistry
  • Terre Haute, IN
National Provider Identifier
1679640940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007323 Issued in IN
Practice address
3438 South 7TH Street
Terre Haute, IN 47802-4017
Phone
(812) 235-9338
Fax
(812) 235-9338
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12007323 IN Primary

Addresses

Primary practice location

3438 South 7TH Street
Terre Haute, IN 47802-4017

Mailing address

2645 Eisenhower Court
Terre Haute, IN 47803-8009
Phone (812) 234-2077

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

LicenseStateTypeSpecialty
12007323INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679640940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 EISENHOWER COURT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478038009",
            "telephone_number": "812-234-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3438 SOUTH 7TH STREET",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024017",
            "telephone_number": "812-235-9338",
            "fax_number": "812-235-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNESS",
        "first_name": "ROBERT",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.