Therese M Bonamer, D.D.S. – Pediatric Dentistry

Key facts

NPI: 1962416552
Entity type: Individual (NPI type 1)
Primary specialty: Pediatric Dentistry 1223P0221X
License: 30.018364 (OH)
Practice address: 13477 Prospect Rd
Suite 102
Strongsville, OH 44149-3867
Phone: (440) 572-5437
NPI assigned: Jul 28, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Strong Smiles Pediatric Dentistry Julie Rudgers Croft DDS LLC Pediatric Dentistry · Strongsville, OH · NPI 1215744776

NPD (past) PEDIATRIC DENTISTRY

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
30.018364	OH	MD	Pediatric Dentist

Practice roles

Organization	Specialty	Status	New patients
Strong Smiles Pediatric Dentistry Julie Rudgers Croft DDS LLC	Pediatric Dentistry	Past since Dec 22, 2024	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatric Dentistry	1223P0221X	30.018364	OH	Yes

Addresses

Primary practice location

13477 Prospect Rd
Suite 102
Strongsville, OH 44149-3867

Mailing address

13477 Prospect Rd
Suite 102
Strongsville, OH 44149-3867
Phone (440) 572-5437

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962416552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13477 PROSPECT RD",
            "address_2": "SUITE 102",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441493867",
            "telephone_number": "440-572-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13477 PROSPECT RD",
            "address_2": "SUITE 102",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441493867",
            "telephone_number": "440-572-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAMER",
        "first_name": "THERESE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.018364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

All providers in Strongsville, OH · Pediatric Dentistry in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.