Somerset Oral & Maxillofacial Surgery LTD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SOMERSET ORAL & MAXILLOFACIAL SURGERY LTD

Doing business as

Rick Bonomo, DMD

Practice address

261 W Main St
Somerset, PA 15501-1560

Phone

(814) 445-7954

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Rick Bonomo, DMD

Title

President/Owner

Phone

(814) 445-7954

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rick Bonomo, DMD Doing business as

Locations

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1821277179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 W MAIN ST",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155011560",
            "telephone_number": "814-445-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 W MAIN ST",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155011560",
            "telephone_number": "814-445-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERSET ORAL & MAXILLOFACIAL SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "BONOMO",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "814-445-7954",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009037660001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rick Bonomo, DMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Somerset, PA
• Providers in Somerset, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.