Brian R Bonczek, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS038406 Issued in PA

Practice address

100 Pricedale Rd
Belle Vernon, PA 15012-1968

Phone

(724) 929-4939

NPI assigned

Aug 10, 2010

Sex

Male

Sole proprietor

Yes

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 PA

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

State licenses

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1811202245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRICEDALE RD",
            "city": "BELLE VERNON",
            "state": "PA",
            "postal_code": "150121968",
            "telephone_number": "724-929-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONCZEK",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Mary Bellissimo, O.D.
• Better Is Better
• BHRS Resources and Consulting
• Robert Eugene Biddle Jr., D.C.
• Amanda Billy, FNP-C
• Mallory Anne Boscan, PA-C
• Lawrence P Boyd III, DC
• David J Brazon, DDS
• Thomas Francis Brockmeyer, MD
• James Locke Brooks III, MD

• General Practice Dentistry in Belle Vernon, PA
• Providers in Belle Vernon, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.