David Fletcher Gundersen, DDS, MPH

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6712-15 Issued in WI

Practice address

12 Virginia Ter
Madison, WI 53726-5338

Phone

(608) 443-8986

NPI assigned

Jun 13, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scenic Bluffs Health Center, Inc

  • Dental Clinic/Center
  • Cashton, WI
  • NPI 1124270178
  NPD (past)

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1255626792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 VIRGINIA TER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537265338",
            "telephone_number": "608-443-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 VIRGINIA TER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537265338",
            "telephone_number": "608-443-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "DAVID",
        "middle_name": "FLETCHER",
        "name_prefix": "Dr.",
        "credential": "DDS, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6712-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trecia D Gulseth, CRNA
• Madelynn Gums, RN
• Caroline Gumz
• Deekshitha Gundala, MBBS
• Susan B Gundeck
• Kirsten Anne Gunderson
• Sarah Gunderson, MS, OTR/L
• Patricia Ann Gundlach, MSSW
• Traci L Gundlach, NP
• Elizabeth Coppoc Gunshor, M.S., CCC-SLP

• General Practice Dentistry in Madison, WI
• Providers in Madison, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.