Brenton Bundrick, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

10327 Issued in NC

Practice address

7204 E Marshville Blvd
Marshville, NC 28103-1191

Phone

(704) 981-1664

NPI assigned

Jun 16, 2016

Last updated

Sep 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brenton Bundrick, DDS, PLLC

  dba Marshville Dental

  • Dental Clinic/Center
  • Marshville, NC
  • NPI 1548724669
  Authorized official Same address or phone
• John Walsh DDS PA

  dba Dentistry of the Carolinas

  • Pediatric Dentistry
  • Gastonia, NC
  • NPI 1285761338
  NPD (past)

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1619327020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7204 E MARSHVILLE BLVD",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281031191",
            "telephone_number": "704-981-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7204 E MARSHVILLE BLVD",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281031191",
            "telephone_number": "704-981-1664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2641 Court Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280541478",
            "country_code": "US",
            "telephone_number": "704-824-6988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNDRICK",
        "first_name": "BRENTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taiwo O Bada
• Baptist Childrens Homes of NC Inc (Stegall Home)
• Sarah Bradley
• Brenton Bundrick, DDS, PLLC (Marshville Dental)
• Wesley Buie
• Charlitta Estie Burruss, SOCIAL WORKER
• Carolina Behavioral Consulting LLC. (Carolina Behavioral)
• Carolina Physical Rehabilitation Services, Inc.
• Nicole Craven Clark, OTR/L
• Community Medical, P.a.

• Dentist in Marshville, NC
• Providers in Marshville, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.