Active NPI
Joseph R. Funderburk DDS Professional LLC
Doing business as Grand Junction Oral Surgery
- Oral and Maxillofacial Surgery (Dentist)
- Grand Junction, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 10676
- Legal business name
- JOSEPH R. FUNDERBURK DDS PROFESSIONAL LLC
- Doing business as
- Grand Junction Oral Surgery
- Practice address
- 613 25 Road
Suite 1
Grand Junction, CO 81505-3607 - Phone
- (970) 241-2820
- Fax
- (970) 248-9553
- NPI assigned
- Apr 17, 2013
- Last updated
- Oct 21, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Joseph R. Funderburk, D.D.S.
- Title
- Owner/Doctor
- Phone
- (970) 241-2820
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 10676 | CO | Primary |
Addresses
Primary practice location
613 25 Road
Suite 1
Grand Junction, CO 81505-3607
Mailing address
613 25 Road
Suite 1
Grand Junction, CO 81505-3607
Phone (970) 241-2820
Other names 1
- Grand Junction Oral Surgery
National Provider Directory
National Provider DirectoryLocations
2532 Patterson Rd
Ste 10
Grand Junction, CO 81505
Phone (970) 241-2820
613 25 Rd
Ste 1
Grand Junction, CO 81505
Phone (970) 241-2820
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Oral and Maxillofacial Surgery (Dentist)
- Grand Junction, CO
- NPI 1205034949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366156800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1634774400000",
"number": "1295179554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 25 ROAD",
"address_2": "SUITE 1",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815053607",
"telephone_number": "970-241-2820",
"fax_number": "970-248-9553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 25 ROAD",
"address_2": "SUITE 1",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815053607",
"telephone_number": "970-241-2820",
"fax_number": "970-248-9553"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOSEPH R. FUNDERBURK DDS PROFESSIONAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-17",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A",
"authorized_official_last_name": "FUNDERBURK",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "R.",
"authorized_official_title_or_position": "OWNER/DOCTOR",
"authorized_official_telephone_number": "970-241-2820",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CO",
"license": "10676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Grand Junction Oral Surgery",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Grand Junction Oral Surgery",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.