Fundora My Dentist. LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FUNDORA MY DENTIST. LLC

Practice address

28550 US 19TH Hwy N
Clearwater, FL 33761

Phone

(786) 247-6079

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Marcel Fundora, DMDNPI 1881218998

Title

Owner

Phone

(727) 300-1594

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marcel Fundora, DMD

  • General Practice Dentistry
  • Clearwater, FL
  • NPI 1881218998
  NPD Authorized official

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1447979331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28550 US 19TH HWY N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33761",
            "telephone_number": "786-247-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28550 US 19TH HWY N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33761",
            "telephone_number": "786-247-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDORA MY DENTIST. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "FUNDORA",
        "authorized_official_first_name": "MARCEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-300-1594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drfundora@fundora-my-dentist.com",
            "affiliation": "N",
            "endpointDescription": "dr email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "28550 US 19th HWY N",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daxton Fulk
• Full Circle Orthopedics PLLC
• Brian William Fullem, DPM
• Suzanne M Fuller, OTR
• Josefina Dumagat Fullerton
• Marcel Fundora, DMD
• Funshine Breeze LLC
• G & R Pharmacy Inc
• G J Cuadra M D P a
• G Stephen Igel MD PA

• Dental Clinic/Center in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.