Individual provider Active NPI

Michael J. Mundenar, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Yardley, PA
National Provider Identifier
1245252659
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS024081L Issued in PA
Practice address
606 Floral Vale Blvd
Yardley, PA 19067-5528
Phone
(215) 504-0600
Fax
(215) 504-0951
NPI assigned
Jul 24, 2006
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS024081L PA Primary

Addresses

Primary practice location

606 Floral Vale Blvd
Yardley, PA 19067-5528

Mailing address

606 Floral Vale Blvd
Yardley, PA 19067-5528
Phone (215) 504-0600

Other identifiers 4

IdentifierTypeStateIssuer
00042493000OtherPAKEYSTONE HEALTH PLAN EAST
68626OtherPAAETNA ID #
166433OtherPAHIGHMARK/BLUE SHIELD
WA190229655OtherPAMEDICARE RR #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000040 PA Practitioner - Maxillofacial Surgery 2961686563 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS024081LPAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J. Mundenar, D.M.D.,P.C. Oral and Maxillofacial Pathology CurrentSince Oct 20, 2010 Accepting new patients

Locations

606 Floral Vale Blvd
Yardley, PA 19067
Phone (215) 504-0600

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, 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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1245252659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 FLORAL VALE BLVD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675528",
            "telephone_number": "215-504-0600",
            "fax_number": "215-504-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 FLORAL VALE BLVD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675528",
            "telephone_number": "215-504-0600",
            "fax_number": "215-504-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDENAR",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS024081L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "00042493000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID #",
            "identifier": "68626",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK/BLUE SHIELD",
            "identifier": "166433",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR #",
            "identifier": "WA190229655",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.