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BONNEY LAKE FAMILY DENTISTRY, PLLC
NPI 1548018526
Dentist - General Practice in Bonney Lake, WA

Active since May 07, 2024
21515 STATE ROUTE 410 E STE A, BONNEY LAKE, WA 98391(253) 826-9000(253) 826-0328 Get Directions Write a Review

NPPES record last updated: May 7, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Bonney Lake Family Dentistry, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BONNEY LAKE FAMILY DENTISTRY, PLLC (NPI 1548018526), doing business as Bonney Lake Family Dentistry, is a healthcare organization registered as a general practice in Bonney Lake, Washington and active in the NPI registry since May 2024. The organization lists Nick Sundiam, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1548018526
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBONNEY LAKE FAMILY DENTISTRY, PLLC
Location Address21515 STATE ROUTE 410 E STE ABonney Lake, WA 98391-4100
Mailing Address21515 State Route 410 E Ste ABonney Lake, WA 98391-4100 · (253) 826-9000 · Fax (253) 826-0328
Phone(253) 826-9000
Fax(253) 826-0328
Organization SubpartNo
Authorized OfficialNick SundiamCredentialing Manager · (719) 300-5933
Enumeration DateMay 7, 2024
NPPES CertifiedMay 7, 2024
✔ NPI 1548018526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
21515 STATE ROUTE 410 E STE A, Bonney Lake, WA 98391
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Other Names 1

Doing Business AsBonney Lake Family Dentistry

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VAN REID D.D.S
Dentist
21515 STATE ROUTE 410 E STE A
BONNEY LAKE, WA 98391
Pierce County (253) 826-9000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bonney Lake Family Dentistry, PLLC's NPI number?

The NPI number for Bonney Lake Family Dentistry, PLLC is 1548018526. It was assigned to this organization in the NPPES registry on May 7, 2024. The provider is doing business as Bonney Lake Family Dentistry.

Where is Bonney Lake Family Dentistry, PLLC located?

Bonney Lake Family Dentistry, PLLC is located at 21515 State Route 410 E Ste A, Bonney Lake, WA 98391. The listed phone number is (253) 826-9000.

What is Bonney Lake Family Dentistry, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Bonney Lake Family Dentistry, PLLC was last updated on May 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.