Nicole Monique Bunch, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17326 Issued in FL

Practice address

5800 Beach Blvd Suite 102
Jacksonville, FL 32207

Phone

(904) 330-0630

Fax

(904) 423-0388

NPI assigned

Mar 5, 2007

Sex

Female

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

Enrolled in FL

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

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1891824934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 BEACH BLVD SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-330-0630",
            "fax_number": "904-423-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 BEACH BLVD SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-330-0630",
            "fax_number": "904-423-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNCH",
        "first_name": "NICOLE",
        "middle_name": "MONIQUE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Bullock
• Erica Bumford
• Cyra Mae Malgapo Bunag, MMSC., PA-C
• Jason Wayne Bunce, MD, MPH
• Chauntay Bunch, CAC
• Christina Bungo, D.O.
• Tiffany Bunk
• Sondra Marie Bunkley
• Kalie Kristine Bunn, M. ED., CCC-SLP
• Taylor Bunn, PHARMD

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; 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.