NPIMap

Organization Active NPI

Bond 2020 Dental, LLC

  • General Practice Dentistry
  • South Bend, IN
National Provider Identifier
1700219912
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008811A Issued in IN
Legal business name
BOND 2020 DENTAL, LLC
Practice address
915 S Ironwood
South Bend, IN 46615-1613
Phone
(574) 288-5252
Fax
(574) 288-7279
NPI assigned
Aug 12, 2013
Organization subpart
Yes
Parent organization
20-20 DENTAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Authorized official

Name
Dr. William Myers, D.D.S.
Title
D.D.S.
Phone
(574) 549-7232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12008811A IN Primary

Addresses

Primary practice location

915 S Ironwood
South Bend, IN 46615-1613

Mailing address

915 S. Ironwood
South Bend, IN 46615-1613
Phone (574) 288-5252

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1700219912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 S. IRONWOOD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466151613",
            "telephone_number": "574-288-5252",
            "fax_number": "574-288-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S IRONWOOD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466151613",
            "telephone_number": "574-288-5252",
            "fax_number": "574-288-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOND 2020 DENTAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "20-20 DENTAL, LLC",
        "enumeration_date": "2013-08-12",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "D.D.S.",
        "authorized_official_telephone_number": "574-549-7232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008811A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.