DR. FRED J BONACCI (NPI# 1558463240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558463240 |
| Entity Type | Individual |
| Full Name | DR. FRED J BONACCI |
| Credential | DMD |
| Practice Address |
672 S River St Ste 209 Plains PA 18705-1034 |
| Practice Telephone | 5708462300 |
| Mailing Telephone | 5708462300 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2018-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
20145 | MA | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DS031389L | PA | Dental Providers |
| Street Address |
672 S RIVER ST STE 209 |
| City | PLAINS |
| State | PA |
| Zip Code | 18705-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316446206 | Mark L Rowan | Physical Therapist | 667 North River Street, Plains, PA 18705 | 2018-02-06 |
| 1588105589 | Maxim Healthcare Services Inc | Home Health | 672 North River St., Suite 102, Plains, PA 18705 | 2017-03-10 |
| 1538572383 | Kevin Loftus | Pharmacist | 20 South River St, Plains, PA 18705 | 2014-06-10 |
| 1831345487 | Terry Lynn Elias | Speech-Language Pathologist | 1014 Morgan Drive, Wilkes-barre, PA 18705 | 2008-08-14 |
| 1578699963 | Renee Elizabeth Edwards | Dentist | 163 S River Street, Plains, PA 18705 | 2007-02-27 |
| 1669568770 | Wyoming Valley Alcohol and Drug Services Inc | Counselor | 437 North Main St., Wilkes Barre, PA 18705 | 2006-10-05 |
| 1912090689 | Emmanuel Egipto Jacob | Acupuncturist | 39 South River Street, Plains, PA 18705 | 2006-10-02 |
| 1336159508 | Albert David Janerich | Physical Medicine & Rehabilitation | 667 S River St, Plains, PA 18705 | 2006-08-09 |
| 1174543094 | Northeast Pedorthic Services Inc | Durable Medical Equipment & Medical Supplies | 234 S River Rd, Plains, PA 18705 | 2006-07-21 |
| 1235118225 | Riverview Orthotics Prosthetics Inc | Prosthetic/Orthotic Supplier | 220 South River St, Suite 204, Plains, PA 18705 | 2006-01-10 |
| Find all providers in zip 18705 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471913 | Martin L. Supowitz, Dmd, Msd, LLC | Dentist | 5433 Walnut St Ste 200, Pittsburgh, PA 15232-3215 | 2020-09-11 |
| 1780239228 | Hatboro Dental & Specialty LLC | Dentist | 122 N York Rd Ste 2, Hatboro, PA 19040-2622 | 2019-08-01 |
| 1679125835 | Amanda Marie Clemente | Dentist | 3501 Terrace St # B89, Pittsburgh, PA 15213-2523 | 2019-07-09 |
| 1235792458 | Fany Briseyda Ocampo | Dentist | 2137 Welsh Rd Ste 2a, Philadelphia, PA 19115-4963 | 2019-04-15 |
| 1043771447 | Kara Deanne Dragone | Dentist | 8890 Royal Manor Dr Apt 302, Allison Park, PA 15101-2783 | 2019-03-27 |
| 1801356423 | Nicholas Anzur | Dentist | 4225 Trindle Rd, Camp Hill, PA 17011-5752 | 2019-03-20 |
| 1992261036 | Manal Sabir | Dentist | 2200 Benjamin Franklin Pkwy Apt S1603, Philadelphia, PA 19130-3618 | 2019-02-13 |
| 1699242024 | Michael S Ayes Dds and Associates Pennsylvania Vi, PC | Dentist | 70 Buckwalter Rd Ste 309, Royersford, PA 19468-1846 | 2018-10-24 |
| 1043736051 | Miriam Ting | Dentist | 250 W Lancaster Ave Ste 215, Paoli, PA 19301-1751 | 2017-08-21 |
| 1104378611 | Natalie Amoa | Dentist | 8021b Castor Ave, Philadelphia, PA 19152-2733 | 2016-10-31 |
| Find all providers with the same taxonomy | ||||
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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.