Provider Demographics
NPI:1225116460
Name:RENDON BONILLA, CLAUDIA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:
Last Name:RENDON BONILLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PARISVILLE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:949-916-1224
Mailing Address - Fax:
Practice Address - Street 1:30021 ALICIA PKWY
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2090
Practice Address - Country:US
Practice Address - Phone:949-363-5880
Practice Address - Fax:949-363-5875
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist