Ann Michelle Bonness, D.D.S.
Individual provider Active NPI General Practice Dentistry · Camby, IN
NPI 1780766006 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1780766006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12010488A (IN)
- Practice address
- 10701 Alliance Dr
Suite F
Camby, IN 46113-8836 - Phone
- (317) 821-1130
- Fax
- (317) 821-1145
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161222000143 | IN | Order and Referring Only - Dentist |
0143501619 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010488A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bonness Family Dentistry PC | Past | Accepting new patients | |
| Arnaaz Dental Group LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12010488A | IN | Yes |
Addresses
Primary practice location
10701 Alliance Dr
Suite F
Camby, IN 46113-8836
Mailing address
10701 Alliance Dr
Suite F
Camby, IN 46113-8836
Phone (317) 821-1130
Other providers in Camby, IN
- Babatunde Afolabi Atilade
- Brittany Suzanne Backer
- Esther Odunola Balogun
- Nisha Bhayani
- Bonness Family Dentistry PC
- Dianna L Boyer
- Rebecca Breitenstein
- Brian Mitchell LLC
- Brighter Way Care LLC
- Erica Marie Broaders
All providers in Camby, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.