Provider Demographics
NPI:1548413396
Name:BOOKMAN, DONALD J (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:BOOKMAN
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:J
Other - Last Name:BOOKMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MS
Mailing Address - Street 1:2806 MACK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5130
Mailing Address - Country:US
Mailing Address - Phone:513-860-5566
Mailing Address - Fax:
Practice Address - Street 1:9667 ASH CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-6052
Practice Address - Country:US
Practice Address - Phone:513-891-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013139122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist