Robert Lusk Bonham, D.D.S. (DENTIST)

Dentist · So. Bend, IN

Individual Active NPI

NPI number 1952605560

Practice location

1222 L.W.E.
So. Bend, IN 46601

Phone: (574) 287-3300
Fax: (574) 287-3301

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NPI record

NPI: 1952605560
Entity type: Individual (Type 1)
Enumeration date: December 23, 2010
Last updated: December 23, 2010
Sole proprietor: Yes

Specialties & taxonomy codes

Taxonomy	Code	License	State
Dentist Primary	`122300000X`	6474	IN

Mailing address

1222 Lincoln Way East
So. Bend, IN 46601

Phone: (574) 287-3300
Fax: (574) 287-3301

About Robert Bonham

Robert Lusk Bonham, D.D.S. (DENTIST) is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1222 L.W.E., So. Bend, IN 46601. The NPI number 1952605560 was assigned on December 23, 2010 and the record was last updated on December 23, 2010.

Robert Bonham lists a license in the registry: #6474 (IN) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Robert Lusk Bonham, D.D.S. (DENTIST)?

The NPI number is 1952605560.

What is the phone number of Robert Bonham?

The phone number listed for the practice location is (574) 287-3300.

Where is Robert Bonham located?

1222 L.W.E., So. Bend, IN 46601.

What is the taxonomy code for Robert Bonham?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.