MEDICARE: J. ROBERT BONO DDS, PC

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	1223G0001X	General Practice Dentistry	011575	MO

General Provider Information

NPI Number	:	1881765089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J. ROBERT BONO DDS, PC

Provider Business Mailing Address
First Line	:	231 NW 72ND ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-1821
Country	:	US
Telephone Number	:	816-436-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 NW 72ND ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-1821
Country	:	US
Telephone Number	:	816-436-5900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES ROBERT BONO
Credential	:	DDS
Telephone Number	:	816-436-5900

Provider Enumeration Date	:	11/11/2006
Last Update Date	:	08/22/2020

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