Organization Active NPI

Joshua M. Van Der Bunt, DMD, LLC

  • Dental Clinic/Center
  • Redmond, OR
National Provider Identifier
1104491521
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
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

Updated by the provider on May 27, 2021

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.