Individual provider Active NPI

Chris B Lundell, DDS

  • General Practice Dentistry
  • Dubuque, IA
National Provider Identifier
1073786992
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6304 Issued in IA
Practice address
2100 Asbury Rd
Suite 7
Dubuque, IA 52001-3091
Phone
(563) 557-8262
Fax
(563) 557-3025
NPI assigned
Apr 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6304 IA Primary

Addresses

Primary practice location

2100 Asbury Rd
Suite 7
Dubuque, IA 52001-3091

Mailing address

2100 Asbury Rd
Suite 7
Dubuque, IA 52001-3091
Phone (563) 557-8262

Other identifiers 1

IdentifierTypeStateIssuer
0151720MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6304IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chris B Lundell DDS PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1073786992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 ASBURY RD",
            "address_2": "SUITE 7",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013091",
            "telephone_number": "563-557-8262",
            "fax_number": "563-557-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ASBURY RD",
            "address_2": "SUITE 7",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013091",
            "telephone_number": "563-557-8262",
            "fax_number": "563-557-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "CHRIS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151720",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.