Individual provider Active NPI

David Y Tambunan, DDS

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1407870538
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009887 Issued in IN
Practice address
8150 Oaklandon Rd
Suite 128
Indianapolis, IN 46236-9525
Phone
(317) 826-8761
Fax
(317) 826-8787
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12009887 IN Primary

Addresses

Primary practice location

8150 Oaklandon Rd
Suite 128
Indianapolis, IN 46236-9525

Mailing address

8150 Oaklandon Rd
Suite 128
Indianapolis, IN 46236-9525
Phone (317) 826-8761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160111001635 IN Order and Referring Only - DentistPractitioner - Dentist 7214239151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009887INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407870538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 OAKLANDON RD",
            "address_2": "SUITE 128",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462369525",
            "telephone_number": "317-826-8761",
            "fax_number": "317-826-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 OAKLANDON RD",
            "address_2": "SUITE 128",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462369525",
            "telephone_number": "317-826-8761",
            "fax_number": "317-826-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBUNAN",
        "first_name": "DAVID",
        "middle_name": "Y",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.