Shannon Bundgaard, R.D.H.

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

002023587 Issued in CO

Practice address

16205 W 64TH Ave
Arvada, CO 80007-7401

Phone

(303) 940-1910

NPI assigned

Oct 10, 2016

Last updated

Oct 10, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1396295861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16205 W 64TH AVE",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800077401",
            "telephone_number": "303-940-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16205 W 64TH AVE",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800077401",
            "telephone_number": "303-940-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDGAARD",
        "first_name": "SHANNON",
        "credential": "R.D.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "002023587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Hygienist in Arvada, CO
• Providers in Arvada, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.