NPI 1003270612

Dominique Bonner, DDS

Practitioner Dentist Fairfax, VA

Practice location

Address: 9547a Fairfax Blvd, Fairfax, VA 22031-4740
Phone: (703) 520-9985

Registered specialties (3)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 0401415681 (VA)

Other Dentist providers in Virginia →

Dentist

Dental Providers Taxonomy 122300000X Licence 16313 (MD)

General Practice Dentistry

Dental Providers Taxonomy 1223G0001X Licence 16313 (MD)

Registry record

NPI: 1003270612
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Apr 2016
Record last updated: 25 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.