Brandon Fredric Bonine

Primary specialty

DentistTaxonomy code 122300000X

License

2901601400 Issued in MI

Practice address

1515 E. Hospital Drive
G1100 Towsley Center
Ann Arbor, MI 48109

Phone

(734) 232-6048

NPI assigned

Jun 16, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1891425328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 GOLF CLUB RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488439001",
            "telephone_number": "517-861-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E. HOSPITAL DRIVE",
            "address_2": "G1100 TOWSLEY CENTER",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48109",
            "telephone_number": "734-232-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONINE",
        "first_name": "BRANDON",
        "middle_name": "FREDRIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bbonine@umich.edu",
            "affiliation": "N",
            "address_1": "1515 E. Hospital Drive",
            "address_2": "G1100 Towsley Center",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kerry L Bondy, PA
• Frank Bongiorno, MD
• Sarah Suzanna Bonick, CRNA
• Phyllis Marie Boniface, MD
• Thomas Bonifer, M.D.
• Avelyn Rose Bonner
• Sidra Bonner, MD
• James Clayton Bonnette, MD
• Russell Bonneville III
• Haley Bonnici

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.