NPIMap

Organization Active NPI

Christopher E. Bonacci DDS MD PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Vienna, VA
National Provider Identifier
1720006661
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
0101057525 Issued in VA
Legal business name
CHRISTOPHER E. BONACCI DDS MD PC
Practice address
361 Maple Ave W
Suite 200
Vienna, VA 22180-4304
Phone
(703) 255-9400
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Authorized official

Name
Dr. Christopher Eugene Bonacci, DDS MDNPI 1609211325
Title
President
Phone
(703) 255-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 0101057525 VA Primary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 0401102631 VA

Addresses

Primary practice location

361 Maple Ave W
Suite 200
Vienna, VA 22180-4304

Mailing address

361 Maple Ave W
Suite 200
Vienna, VA 22180-4304
Phone (703) 255-9400

National Provider Directory

National Provider Directory

Locations

361 Maple Ave W
Ste 200
Vienna, VA 22180
Phone (703) 255-9400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316736000000",
    "number": "1720006661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 MAPLE AVE W",
            "address_2": "SUITE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804304",
            "telephone_number": "703-255-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 MAPLE AVE W",
            "address_2": "SUITE 200",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804304",
            "telephone_number": "703-255-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER E. BONACCI DDS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-09-23",
        "status": "A",
        "authorized_official_last_name": "BONACCI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-255-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0101057525",
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401102631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.