Active NPI
John P Lundgren, D.D.S., M.S.
- Endodontics
- Jacksonville, FL
National Provider Identifier
1568585628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN16568
- Practice address
- 7740 Point Meadows Dr
Suite 3B
Jacksonville, FL 32256-9179 - Phone
- (904) 517-5090
- Fax
- (904) 517-5091
- NPI assigned
- Apr 6, 2007
- Last updated
- Jan 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN16568 | FL | Primary |
Addresses
Primary practice location
7740 Point Meadows Dr
Suite 3B
Jacksonville, FL 32256-9179
Mailing address
7740 Point Meadows Dr
Suite 3B
Jacksonville, FL 32256-9179
Phone (904) 517-5090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 10, 2022 through May 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN16568 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231891200000",
"number": "1568585628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7740 POINT MEADOWS DR",
"address_2": "SUITE 3B",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322569179",
"telephone_number": "904-517-5090",
"fax_number": "904-517-5091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7740 POINT MEADOWS DR",
"address_2": "SUITE 3B",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322569179",
"telephone_number": "904-517-5090",
"fax_number": "904-517-5091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDGREN",
"first_name": "JOHN",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2009-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN16568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.