NPIMap

Organization Active NPI

Lundgrin Dental Association CHTD.

  • General Practice Dentistry
  • Salina, KS
National Provider Identifier
1245367077
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4696 Issued in KS
Legal business name
LUNDGRIN DENTAL ASSOCIATION CHTD.
Practice address
909 E Wayne Ave
Salina, KS 67401-2201
Phone
(785) 825-5473
Fax
(785) 825-8965
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jerry R Lundgrin, DDSNPI 1174650923
Title
President
Phone
(785) 825-5473

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 4696 KS Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6929 KS

Addresses

Primary practice location

909 E Wayne Ave
Salina, KS 67401-2201

Mailing address

PO Box 1424
Salina, KS 67402-1424
Phone (785) 825-5473

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245367077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1424",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674021424",
            "telephone_number": "785-825-5473",
            "fax_number": "785-825-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E WAYNE AVE",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674012201",
            "telephone_number": "785-825-5473",
            "fax_number": "785-825-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNDGRIN DENTAL ASSOCIATION CHTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUNDGRIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-825-5473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "4696",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6929",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.