Kenneth Barry Bundy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1138 Issued in NM

Practice address

4233 Montgomery Blvd NE
Suite 120W
Albuquerque, NM 87109-6749

Phone

(505) 884-7556

Fax

(505) 884-8716

NPI assigned

Jul 31, 2006

Sex

Male

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

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407862352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4233 MONTGOMERY BLVD NE",
            "address_2": "SUITE 120W",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096749",
            "telephone_number": "505-884-7556",
            "fax_number": "505-884-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 MONTGOMERY BLVD NE",
            "address_2": "SUITE 120W",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096749",
            "telephone_number": "505-884-7556",
            "fax_number": "505-884-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDY",
        "first_name": "KENNETH",
        "middle_name": "BARRY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carletta Sarah Bullock, M.D.
• Rene Alejandro Bulnes Vides, MD
• Brenda Bumphrey, RN
• James Marion Bunch II, MD
• Jasmine Bundick, BHT
• Dorian Bunn
• Princeten Bunn
• Aubrey Bunnenberg
• Sarah Bunting
• Shawn Bunton

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.