MEDICARE: BONNIE VIEW DENTAL AND ORTHODONTICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry

General Provider Information

NPI Number	:	1851050876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BONNIE VIEW DENTAL AND ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	6181 BONNIE VIEW RD # 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-5149
Country	:	US
Telephone Number	:	214-432-0204
Fax Number	:	214-432-0213

Provider Business Practice Location Address
First Line	:	6181 BONNIE VIEW RD # 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-5149
Country	:	US
Telephone Number	:	214-432-0204
Fax Number	:	214-432-0213

Authorized Official
Title or Position	:	OWNER
Name	:	RAHUL JOSHI
Credential	:	DDS
Telephone Number	:	480-747-5129

Provider Enumeration Date	:	12/17/2021
Last Update Date	:	12/22/2021

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