DR. BONNIE BOUDREAUX (NPI# 1538419023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538419023 |
| Entity Type | Individual |
| Full Name | DR. BONNIE BOUDREAUX |
| Credential | D.M.D. |
| Practice Address |
Joel Dental Clinic Bldg M4861 Attn: Mr. Charles Bernatovitz Fort Bragg NC 28310-0001 |
| Practice Telephone | 9106432196 |
| Mailing Telephone | 9106432196 |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2017-04-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 9252 | KY | Dental Providers |
| Street Address |
JOEL DENTAL CLINIC BLDG M4861 ATTN: MR. CHARLES BERNATOVITZ |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700498631 | Jaclyn Jennifer Willis | Dentist | Ardennes Street, Fort Bragg, NC 28307 | 2020-08-21 |
| 1487265039 | John Michael Mckelvey Jr. | Dentist | 6238 Ardennes St, Fort Bragg, NC 28310-0001 | 2020-08-16 |
| 1447805254 | Ross Carroll | Dentist | 1700 Goldberg St, Fort Bragg, NC 28310-0001 | 2019-08-08 |
| 1003398850 | Bailey Moorhead | Dentist | Bldg C-6238 Ardennes Road, Fort Bragg, NC 28307 | 2018-08-29 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1528546322 | Michael J Rethman | Dentist | Bldg M4861 Logistics Avenue Joel Dental Clinic, Fort Bragg, NC 28310-7302 | 2018-08-02 |
| 1245749324 | Michael Stewart Almony | Dentist | Bldg C-6238 Ardennes St, Fort Bragg, NC 28310-0001 | 2017-09-21 |
| 1609392034 | Elliot James Devinney | Dentist | Usa Dental Activity, Attn: Mcds Na B, Bldg 6837 Normandy Drive, Fort Bragg, NC 28310-7302 | 2017-08-17 |
| 1093231425 | Walter Garwood Hinman V | Dentist | Bldg 6837 Normandy Drive Attn: Mcds Na B, Fort Bragg, NC 28310-0001 | 2017-08-17 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.