Thomas Alan Bunner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008775A Issued in IN

Practice address

9417 Saint Joe Center Rd
Fort Wayne, IN 46835-9259

Phone

(260) 480-4800

NPI assigned

Apr 3, 2007

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

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1487775953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9417 SAINT JOE CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468359259",
            "telephone_number": "260-486-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9417 SAINT JOE CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468359259",
            "telephone_number": "260-480-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNER",
        "first_name": "THOMAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008775A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Renee Bultemeier, CRNA
• Marlene Clare Bultemeyer, MD
• Cathy Bumgardner, SLP
• Megan Marie Bunn
• Abbey K. Bunnell, NP
• Kathren A Bunt, L. AC.
• John Anthony Buonocore, D.O.
• Brent D. Burch, OD
• Katelyn Burcham, RBT
• Kenneth Alan Burckardt, M.D.

• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.