Provider Demographics
NPI:1124112966
Name:BONELLI, PEPPINO (DDS)
Entity type:Individual
Prefix:DR
First Name:PEPPINO
Middle Name:
Last Name:BONELLI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WOODCREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604
Mailing Address - Country:US
Mailing Address - Phone:914-831-0828
Mailing Address - Fax:
Practice Address - Street 1:1475 ASTOR AVENUE
Practice Address - Street 2:DRS DARRIGO AND BONELLI DDS LLP
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469
Practice Address - Country:US
Practice Address - Phone:718-653-2411
Practice Address - Fax:718-654-0035
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047708NY1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice