Individual provider Active NPI

Bonnie Berman Henick, DMD

  • Dentist
  • Leonia, NJ
National Provider Identifier
1760654792
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22D101387600 Issued in NJ
Practice address
314 Fort Lee Rd
Leonia, NJ 07605-1813
Phone
(201) 585-8555
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22D101387600 NJ Primary

Addresses

Primary practice location

314 Fort Lee Rd
Leonia, NJ 07605-1813

Mailing address

314 Fort Lee Rd
Leonia, NJ 07605-1813
Phone (201) 585-8555

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
22D101387600NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1760654792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 FORT LEE RD",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076051813",
            "telephone_number": "201-585-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 FORT LEE RD",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076051813",
            "telephone_number": "201-585-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENICK",
        "first_name": "BONNIE",
        "middle_name": "BERMAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D101387600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonia, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.