Provider Demographics
NPI:1992067748
Name:BONEH, JORDANA ARIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:JORDANA
Middle Name:ARIELLE
Last Name:BONEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JORDANA
Other - Middle Name:ARIELLE
Other - Last Name:HIKRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2350 W HORIZON RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5075
Mailing Address - Country:US
Mailing Address - Phone:702-564-8556
Mailing Address - Fax:702-564-4485
Practice Address - Street 1:2350 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5075
Practice Address - Country:US
Practice Address - Phone:702-564-8556
Practice Address - Fax:702-564-4485
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15856208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics