Active NPI
James Philip Bonner, DMD
- Dentist
- Charlotte, NC
National Provider Identifier
1740959485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12472
- Practice address
- 6849 Fairview Rd Ste 200
Charlotte, NC 28210-3664 - Phone
- (910) 520-5748
- NPI assigned
- Sep 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12472 | NC | Primary |
Addresses
Primary practice location
6849 Fairview Rd Ste 200
Charlotte, NC 28210-3664
Mailing address
156 Great Oak Dr
Hampstead, NC 28443-2142
Phone (910) 520-5748
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12472 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630972800000",
"number": "1740959485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 GREAT OAK DR",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "284432142",
"telephone_number": "910-520-5748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6849 FAIRVIEW RD STE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103664",
"telephone_number": "910-520-5748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "JAMES",
"middle_name": "PHILIP",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-07",
"last_updated": "2021-09-07",
"certification_date": "2021-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "12472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.