Arthur Jackson Mund III, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

122300000X Issued in TX

Practice address

4620 Citylake Blvd W
Fort Worth, TX 76132-3695

Phone

(817) 263-0202

Fax

(817) 927-7197

NPI assigned

Aug 16, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

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.

• Fort Worth Dental

  • Dentist
  • Fort Worth, TX
  • NPI 1104939024
  NPD (past) Authorized official

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1780797787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 CITYLAKE BLVD W",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323695",
            "telephone_number": "817-263-0202",
            "fax_number": "817-927-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 CITYLAKE BLVD W",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323695",
            "telephone_number": "817-263-0202",
            "fax_number": "817-927-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUND",
        "first_name": "ARTHUR",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "122300000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX PROVIDER #",
            "identifier": "25DG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROV #",
            "identifier": "809903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "84D742",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana I Mummert, MD
• Ashleigh Mumphord, BS, IONM
• Alhaji Mahama Mumuni, PAC
• Munazza S. Sethi M.D, P.a
• Jennifer M Muncie, R.D.,L.D.
• Justin Dain Mund, DDS
• Giri D Mundluru, M.D.
• Melissa Mundo, MS, OTR/L
• Nickolas Mundo
• Lauren Mundt

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.