David George Bonfante, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

030808 Issued in NY

Practice address

3673 Essex Rd
Suite 2
Willsboro, NY 12996

Phone

(518) 963-7307

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Willsboro Dental, PC

  • Dentist
  • Willsboro, NY
  • NPI 1457668758
  NPD (past) Authorized official

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1720015100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3673 ESSEX RD",
            "address_2": "PO BOX 310",
            "city": "WILLSBORO",
            "state": "NY",
            "postal_code": "12996",
            "telephone_number": "518-963-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3673 ESSEX RD",
            "address_2": "SUITE 2",
            "city": "WILLSBORO",
            "state": "NY",
            "postal_code": "12996",
            "telephone_number": "518-963-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFANTE",
        "first_name": "DAVID",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "030808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee T Ackley, RPA-C
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• Adirondack Apothecary LLC
• Associated Community Action of the North East Adirondack Region, Inc.
• Donna Ann Brown-Joerg
• Brian Callahan, P.A.
• Karen Crowningshield
• Essential Adirondack Therapy License Clinical Social Work, PLLC.
• Gratitude for Wellness Acupuncture

• Dentist in Willsboro, NY
• Providers in Willsboro, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.