NPIMap

Organization Active NPI

Mendon Dental Center

  • General Practice Dentistry
  • Mendon, NY
National Provider Identifier
1629379912
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42060 Issued in NY
Legal business name
MENDON DENTAL CENTER
Practice address
30 Assembly Dr
Suite 102
Mendon, NY 14506-9608
Phone
(585) 624-5886
Fax
(585) 624-7395
NPI assigned
Nov 3, 2010
Last updated
Nov 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Authorized official

Name
Dr. Ann Katherine Kunkel, D.D.S.NPI 1184758443
Title
Owner
Phone
(585) 624-5886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 42060 NY Primary

Addresses

Primary practice location

30 Assembly Dr
Suite 102
Mendon, NY 14506-9608

Mailing address

30 Assembly Dr
P.O. Box 399
Mendon, NY 14506-9608
Phone (585) 624-5886

Other identifiers 1

IdentifierTypeStateIssuer
01143282MedicaidNY

Other names 1

  • Ann K. Kunkel, DDS Other name

National Provider Directory

National Provider Directory

Locations

30 Assembly Dr
Mendon, NY 14506

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1629379912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ASSEMBLY DR",
            "address_2": "P.O. BOX 399",
            "city": "MENDON",
            "state": "NY",
            "postal_code": "145069608",
            "telephone_number": "585-624-5886",
            "fax_number": "585-624-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ASSEMBLY DR",
            "address_2": "SUITE 102",
            "city": "MENDON",
            "state": "NY",
            "postal_code": "145069608",
            "telephone_number": "585-624-5886",
            "fax_number": "585-624-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDON DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "KUNKEL",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-624-5886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "42060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01143282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ann K. Kunkel, DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mendon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.