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Deactivated NPI 1225180649 Deactivated / Inactive NPI Male Practitioner

Dr. John Nicholas Bardonner , DMD

Dentist - General Practice • Canby, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Bardonner has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 17, 2007
NPI Deactivation Date October 09, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. John Bardonner, DMD was a registered Dentist - General Practice practicing in Canby, CA. Throughout an active medical career spanning 13 years, Dr. Bardonner provided care at the practice location at 670 COUNTY ROAD 83 until profile deactivation on 2020-10-09.

Practice Location & Contact Primary Location

Practice Address

670 County Road 83

Canby, CA 960159722

Telephone 5302334140
Fax 5302334140
Associated Practice Facility / Clinic
🏢 I'sot Inc Facility NPI 1528063153

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Canby, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Canby, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA CA57172

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Lorna Boland

Registered Nurse

NPI 1053301689
Virginia Hassler , FNP

Nurse Practitioner - Family

NPI 1467442079

Family Nurse Practitioner

Susan Burger

Dental Hygienist

NPI 1760473706
Dr. Raymond Mandel , PhD

Psychologist - Clinical

NPI 1841280435

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 09, 2020

Record deactivated on October 09, 2020

NPI Profile Active December 09, 2010

NPI status registered as active in NPPES database

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Updated Practice Location December 09, 2010

Registered at 670 COUNTY ROAD 83, CANBY, CA 960159722 (Tel: 5302334140)

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Updated Business Mailing Address December 09, 2010

Registered at 670 COUNTY ROAD 83, CANBY, CA 960153022 (Tel: 5302334641)

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Provider Name / Credentials Updated December 09, 2010

Recorded as JOHN BARDONNER, D.M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 09, 2010

Dentist (License #CA57172 in CA)

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Initial NPI Registration & Enumeration January 17, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1225180649
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 17, 2007
Last Update: December 09, 2010
Deactivation Date: October 09, 2020

Mailing Address

670 County Road 83

Canby, CA 960153022

Phone: 5302334641

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.