NPIMap

Organization Active NPI

Gayle Y. Lundtvedt, D.M.D., P.C.

  • Dental Clinic/Center
  • Sierra Vista, AZ
National Provider Identifier
1871644211
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D6233 Issued in AZ
Legal business name
GAYLE Y. LUNDTVEDT, D.M.D., P.C.
Practice address
1993 Frontage Rd
Suite 208
Sierra Vista, AZ 85635-4633
Phone
(520) 458-4646
Fax
(520) 803-0626
NPI assigned
Jan 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Authorized official

Name
Dr. Gayle Y Lundtvedt, DMDNPI 1831124239
Title
President
Phone
(520) 458-4646

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
Dental Clinic/Center 261QD0000X D6233 AZ Primary

Addresses

Primary practice location

1993 Frontage Rd
Suite 208
Sierra Vista, AZ 85635-4633

Mailing address

1993 Frontage Rd
Suite 208
Sierra Vista, AZ 85635-4633
Phone (520) 458-4646

National Provider Directory

National Provider Directory

Locations

1993 Frontage Rd
Ste 208
Sierra Vista, AZ 85635
Phone (520) 458-4646

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1871644211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1993 FRONTAGE RD",
            "address_2": "SUITE 208",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354633",
            "telephone_number": "520-458-4646",
            "fax_number": "520-803-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 FRONTAGE RD",
            "address_2": "SUITE 208",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354633",
            "telephone_number": "520-458-4646",
            "fax_number": "520-803-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAYLE Y. LUNDTVEDT, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-14",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "LUNDTVEDT",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-458-4646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "D6233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.