Individual provider Active NPI

Zoran Bundalo, DMD MS BSE (HON)

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1417437567
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D010141 Issued in AZ
Practice address
4045 E Bell Rd Ste 115
Phoenix, AZ 85032-2237
Phone
(602) 482-5100
NPI assigned
Aug 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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 D010141 AZ Primary

Addresses

Primary practice location

4045 E Bell Rd Ste 115
Phoenix, AZ 85032-2237

Mailing address

4045 E Bell Rd Ste 115
Phoenix, AZ 85032-2237
Phone (602) 482-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D010141AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
LB Dental Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1417437567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD STE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322237",
            "telephone_number": "602-482-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD STE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322237",
            "telephone_number": "602-482-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDALO",
        "first_name": "ZORAN",
        "name_prefix": "Dr.",
        "credential": "DMD MS BSE (HON)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.