Provider Demographics
NPI:1437369444
Name:BOND, JOHN URBAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:URBAN
Last Name:BOND
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 1:120 S DENTON TAP RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3297
Mailing Address - Country:US
Mailing Address - Phone:469-635-1105
Mailing Address - Fax:469-635-1108
Practice Address - Street 1:120 S DENTON TAP RD
Practice Address - Street 2:SUITE 210
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3297
Practice Address - Country:US
Practice Address - Phone:469-635-1105
Practice Address - Fax:469-635-1108
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16129122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1905661OtherUNITED/CONCORDIA
TX211977801Medicaid
TX211977802Medicaid
1528278132OtherBLUE CROSS BLUE SHIELD
TX211977805Medicaid