Active NPI
Joshua M. Van Der Bunt, DMD, LLC
- Dental Clinic/Center
- Redmond, OR
National Provider Identifier
1104491521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- JOSHUA M. VAN DER BUNT, DMD, LLC
- Practice address
- 2127 S Highway 97 Ste 210
Redmond, OR 97756-2656 - Phone
- (954) 249-8066
- NPI assigned
- May 27, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joshua Van Der Bunt, DMD
- Title
- Owner
- Phone
- (954) 249-8066
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
2127 S Highway 97 Ste 210
Redmond, OR 97756-2656
Mailing address
61054 SE Marble Mountain LN
Bend, OR 97702-9386
Phone (954) 249-8066
National Provider Directory
National Provider DirectoryLocations
2127 S Highway 97
Ste 210
Redmond, OR 97756
Phone (954) 249-8066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1622073600000",
"number": "1104491521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61054 SE MARBLE MOUNTAIN LN",
"city": "BEND",
"state": "OR",
"postal_code": "977029386",
"telephone_number": "954-249-8066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2127 S HIGHWAY 97 STE 210",
"city": "REDMOND",
"state": "OR",
"postal_code": "977562656",
"telephone_number": "954-249-8066"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOSHUA M. VAN DER BUNT, DMD, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A",
"authorized_official_last_name": "VAN DER BUNT",
"authorized_official_first_name": "JOSHUA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "954-249-8066",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.