NPIMap

Organization Active NPI

David W Bonderer DDS PLLC

  • Dentist
  • Gautier, MS
National Provider Identifier
1891957544
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
163974 Issued in MS
Legal business name
DAVID W BONDERER DDS PLLC
Practice address
2808 Hwy 90
Suite 1
Gautier, MS 39553
Phone
(228) 497-2424
Fax
(228) 497-0621
NPI assigned
Jun 25, 2008
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dede J Bonderer
Title
Office Manager
Phone
(228) 497-2424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 163974 MS Primary

Addresses

Primary practice location

2808 Hwy 90
Suite 1
Gautier, MS 39553

Mailing address

PO Box 68
Gautier, MS 39553
Phone (228) 497-2424

National Provider Directory

National Provider Directory

Locations

2808 Highway 90
Ste 1
Gautier, MS 39553
Phone (228) 497-2424

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1891957544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "39553",
            "telephone_number": "228-497-2424",
            "fax_number": "228-497-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 HWY 90",
            "address_2": "SUITE 1",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "39553",
            "telephone_number": "228-497-2424",
            "fax_number": "228-497-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W BONDERER DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "BONDERER",
        "authorized_official_first_name": "DEDE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "228-497-2424"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "163974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gautier, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.