Troy C Bonin, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

TX17133 Issued in TX

Practice address

5403 FM 1488 Rd
Ste a-7 (Republic of Texas)
Magnolia, TX 77354-2524

Phone

(281) 259-6717

NPI assigned

Jul 16, 2008

Last updated

Jul 16, 2008By the provider in NPPES

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 TX

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": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1881858017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 FM 1488 RD STE A-7",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773542524",
            "telephone_number": "281-259-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5403 FM 1488 RD",
            "address_2": "STE A-7 (REPUBLIC OF TEXAS)",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773542524",
            "telephone_number": "281-259-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIN",
        "first_name": "TROY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "TX17133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Magnolia, TX
• Providers in Magnolia, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.