Individual provider Active NPI

Hugh Thomas Wunderlich, DDS

  • General Practice Dentistry
  • Palm Harbor, FL
National Provider Identifier
1558370916
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 10206 Issued in FL
Practice address
32224 US Highway 19 N
Palm Harbor, FL 34684-3707
Phone
(727) 789-1212
Fax
(727) 789-3713
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

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 DN 10206 FL Primary

Addresses

Primary practice location

32224 US Highway 19 N
Palm Harbor, FL 34684-3707

Mailing address

32224 US Highway 19 N
Palm Harbor, FL 34684-3707
Phone (727) 789-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180815000553 FL Order and Referring Only - DentistPractitioner - Dentist 4183973787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 10206FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558370916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32224 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843707",
            "telephone_number": "727-789-1212",
            "fax_number": "727-789-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32224 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843707",
            "telephone_number": "727-789-1212",
            "fax_number": "727-789-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "HUGH",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 10206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.