Individual provider Active NPI

Laura Dawn Sundmark, BA, DDS

  • General Practice Dentistry
  • Fayetteville, NC
National Provider Identifier
1083379994
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12255 Issued in NC
Practice address
600 Executive PL
Fayetteville, NC 28305-5124
Phone
(910) 484-6145
NPI assigned
Nov 4, 2021
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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 12255 NC Primary

Addresses

Primary practice location

600 Executive PL
Fayetteville, NC 28305-5124

Mailing address

3420 Woodford Cir Apt 18
Fayetteville, NC 28314-2658
Phone (651) 263-1786

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)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
12255NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Hedgecoe, D.D.S., P.a. General Practice PastSince Nov 9, 2021 Accepting new patients
Hedgecoe Dentistry General Practice PastSince Nov 9, 2021 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1083379994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 WOODFORD CIR APT 18",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142658",
            "telephone_number": "651-263-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EXECUTIVE PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055124",
            "telephone_number": "910-484-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDMARK",
        "first_name": "LAURA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "BA, DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.