Luka Bundalo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019 Issued in IL

Practice address

2925 W Touhy Ave
Chicago, IL 60645-2937

Phone

(773) 465-2600

Fax

(773) 465-2724

NPI assigned

May 20, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• LB Dental Inc.

  • Dentist
  • Phoenix, AZ
  • NPI 1407247489
  NPD (past) Authorized official

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1366609125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 W TOUHY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452937",
            "telephone_number": "773-465-2600",
            "fax_number": "773-465-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 W TOUHY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452937",
            "telephone_number": "773-465-2600",
            "fax_number": "773-465-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDALO",
        "first_name": "LUKA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6073",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Milton Bumsted, M.D.
• Andrea Bunch, PT
• Darlene E Bunch, LCSW
• Jazmin Bunch
• Sarah Bunch, M.D.
• Nour Khalid Bundogji, MD
• Jonathan Bundy, MD
• Missy Jean Bundy, PSY.D.
• Brandon M Bungo, MD
• Miguel Bunker-Huertas, DC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.