CHRISTOPHER E. BONACCI DDS MD PC (NPI# 1720006661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720006661 |
Entity Type | Organization |
Organization Name | CHRISTOPHER E. BONACCI DDS MD PC |
Practice Address |
361 Maple Ave W Suite 200 Vienna VA 22180-4304 |
Practice Telephone | 7032559400 |
Mailing Telephone | 7032559400 |
Enumeration Date | 2006-07-18 |
Last Update Date | 2011-09-23 |
Authorized Official Name | DR. CHRISTOPHER EUGENE BONACCI (PRESIDENT) |
Authorized Official Telephone | 7032559400 |
Authorized Official Credential | DDS MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
0401102631 | VA | Ambulatory Health Care Facilities |
Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
0101057525 | VA | Ambulatory Health Care Facilities |
Street Address |
361 MAPLE AVE W SUITE 200 |
City | VIENNA |
State | VA |
Zip Code | 22180-4304 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609211325 | Christopher E Bonacci | Dentist | 361 Maple Ave W, Vienna, VA 22180-4304 | 2013-05-08 |
1992826333 | Sang Yoon Kim | Dentist | 361 Maple Ave W, Suite 200, Vienna, VA 22180-4304 | 2007-04-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023519386 | Erika Ruiz | Dentist | Ave Miraflores #6439 - A, Tijuana, BAJA CALIFORNIA 22180 | 2018-02-22 |
1992220206 | John Alexander | Massage Therapist | 122 Maple Ave W, Vienna, VA 22180 | 2017-08-08 |
1548620214 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 2675 Avenir Place, Vienna, VA 22180 | 2016-02-24 |
1992163190 | Peter J Mcgarry | Chiropractor | 301 Maple Ave. W. Ste 515, Vienna, VA 22180 | 2016-02-02 |
1629479563 | Jaimie Vettichira Samuel | Pediatrics | 100 East St Se Ste 301, Vienna, VA 22180 | 2014-09-10 |
1326454562 | N R Emad Dds PC | Dentist | 307 F Maple Ave. W #100, Vienna, VA 22180 | 2014-07-09 |
1881020568 | Albert Juan Garcia | Obstetrics & Gynecology | 926 Fairway Dr., N.e., Vienna, VA 22180 | 2013-09-25 |
1295174662 | Sallie Twentyman | Social Worker | 129 Park St Ne Ste 12b, Vienna, VA 22180 | 2013-06-19 |
1124390992 | Gilda T. Clarke | Counselor | 133 Park St. Ne, Vienna, VA 22180 | 2012-02-08 |
1740573898 | Metro Eyes LLC | Technician/Technologist | 256 E Maple Avenue, Vienna, VA 22180 | 2011-05-24 |
Find all providers in zip 22180 |
Taxonomy Code | 261QS0112X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225425465 | Integrative Implant Services, LLC | Clinic/Center | 6845 Elm. St., Ste. 225, Mclean, VA 22102-3834 | 2015-04-24 |
1235424557 | Fredericksburg Regional Oral Surgery Center Inc | Clinic/Center | 210 Executive Center Pkwy, Fredericksburg, VA 22401-3107 | 2011-06-15 |
1538629134 | Eric J Smith Dds PC | Clinic/Center | 22525 Timberlake Rd, Lynchburg, VA 24502-7307 | 2019-03-21 |
1922579796 | Eric J Smith Dds PC | Clinic/Center | 22525 Timberlake Rd, Lynchburg, VA 24502-7307 | 2018-12-05 |
1124572417 | Isle of Wight Family & Cosmetic Dentistry PC | Clinic/Center | 4053 Taylor Rd, Suite J, Chesapeake, VA 23321-5537 | 2016-08-04 |
1386050532 | Tristate Oral Surgery Plc | Clinic/Center | 5659 Columbia Pike, Suite 100, Falls Church, VA 22041-2878 | 2014-07-09 |
1831526995 | Northern Virginia Center for Oral and Facial Surgery | Clinic/Center | 4211 Fairfax Corner Ave E, Suite 235, Fairfax, VA 22030-8622 | 2013-10-03 |
1215292255 | Paul E. Prillaman, IIi, Dds, Plc | Clinic/Center | 905 Battlefield Blvd N, 101, Chesapeake, VA 23320-4875 | 2012-07-05 |
1891068417 | Middle Peninsula Oral and Facial Surgery LLC | Clinic/Center | 7547 Medical Dr, Gloucester, VA 23061-4351 | 2012-02-13 |
1386818136 | Drs. Gold and Abbott, Ltd. | Clinic/Center | 1940 Braeburn Dr, Salem, VA 24153-7383 | 2008-04-14 |
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.