Kenneth L. Mundy D.D.S., P.a.

Primary specialty

DentistTaxonomy code 122300000X

License

DN6080 Issued in FL

Legal business name

KENNETH L. MUNDY D.D.S., P.A.

Practice address

4326 Highland Park Blvd
Lakeland, FL 33813-1647

Phone

(863) 644-6418

Fax

(863) 644-6419

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Judy K Mundy

Title

Administrator

Phone

(863) 644-6418

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Lawrence Mundy, DDS

  • General Practice Dentistry
  • Lakeland, FL
  • NPI 1407879687
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1124281977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4326 HIGHLAND PARK BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131647",
            "telephone_number": "863-644-6418",
            "fax_number": "863-644-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4326 HIGHLAND PARK BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131647",
            "telephone_number": "863-644-6418",
            "fax_number": "863-644-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH L. MUNDY D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "MUNDY",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "863-644-6418",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN6080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Kennedy Jr.
• Rebecca Marie Kennedy, HAS
• Robert Kennedy
• Shelby Kennedy, PSYD
• Susan Emily Kennedy
• Katera Kennon
• Karlyne Kenny
• David Willis Kent, LCSW
• Paul Stephen Kent Jr., ARNP
• Kern Chiropractic Clinic

• Dentist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.