Individual provider Active NPI

James O. Cunnington II, DDS, FAGD

  • General Practice Dentistry
  • Bend, OR
National Provider Identifier
1265587372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8312 Issued in OR
Practice address
1693 SW Chandler Ave
#280
Bend, OR 97702-3236
Phone
(541) 322-8881
Fax
(541) 322-0424
NPI assigned
Jan 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D8312 OR Primary

Addresses

Primary practice location

1693 SW Chandler Ave
#280
Bend, OR 97702-3236

Mailing address

1693 SW Chandler Ave
#280
Bend, OR 97702-3236
Phone (541) 322-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20150803000908 WA Order and Referring Only - DentistPractitioner - Dentist 0840504999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D8312ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
James O Cunnington DDS PastSince Apr 1, 2015 Accepting new patients

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265587372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1693 SW CHANDLER AVE",
            "address_2": "#280",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023236",
            "telephone_number": "541-322-8881",
            "fax_number": "541-322-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 SW CHANDLER AVE",
            "address_2": "#280",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023236",
            "telephone_number": "541-322-8881",
            "fax_number": "541-322-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGTON",
        "first_name": "JAMES",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS, FAGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.