Joseph R. Funderburk DDS Professional LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10676 Issued in CO

Legal business name

JOSEPH R. FUNDERBURK DDS PROFESSIONAL LLC

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Other names 1

• Grand Junction Oral Surgery Doing business as

Locations

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"
        }
    ]
}

• Erika Lynn Jordan
• Laura K Jordan, CCC-SLP
• Andrea Lynn Jordheim, D.C.
• Thomas Robert Jorgensen
• Joseph R Funderburk, DDS
• Paul Joslyn
• Kathleen Michelle Joy, DO
• Heather V. Juanes, LPC
• Beverly Suzanne Jucknath, APRN-C
• Judd M Chamberlain, DDS, PC

• Oral and Maxillofacial Surgery (Dentist) in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• 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.

Verify at the official NPI Registry.