NPIMap

Individual provider Active NPI

David Byron Bonebreak, D.D.S. M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hanover, MD
National Provider Identifier
1902102254
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
14232 Issued in MD
Practice address
7556 Teague Rd Ste 106
Hanover, MD 21076-1969
Phone
(410) 799-8220
NPI assigned
Feb 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 14232 MD Primary

Addresses

Primary practice location

7556 Teague Rd Ste 106
Hanover, MD 21076-1969

Mailing address

12240 Pleasant Springs CT
Fulton, MD 20759-9647
Phone (443) 956-5814

Other practice location 1

8191 Maple Lawn Blvd Ste E
Fulton, MD 20759-2535
Phone (410) 381-1077

Other practice location 2

12230 Clarksville Pike
Suite M
Clarksville, MD 21029
Phone (410) 381-1077

Other practice location 3

8640 Guilford Rd
Suite 233
Columbia, MD 21046-2655
Phone (410) 381-1077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14232MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanguard Orthodontics LLC Past Accepting new patients
David Bonebreak DDS Ms LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902102254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12240 PLEASANT SPRINGS CT",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207599647",
            "telephone_number": "443-956-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7556 TEAGUE RD STE 106",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761969",
            "telephone_number": "410-799-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8191 Maple Lawn Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "MD",
            "postal_code": "207592535",
            "country_code": "US",
            "telephone_number": "410-381-1077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12230 Clarksville Pike",
            "address_2": "Suite M",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "MD",
            "postal_code": "21029",
            "country_code": "US",
            "telephone_number": "410-381-1077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8640 Guilford Rd",
            "address_2": "Suite 233",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210462655",
            "country_code": "US",
            "telephone_number": "410-381-1077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONEBREAK",
        "first_name": "DAVID",
        "middle_name": "BYRON",
        "name_prefix": "Dr.",
        "credential": "D.D.S. M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "14232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.