Active NPI
Erin Van Gundy, DDS
- Dentist
- Phoenix, AZ
National Provider Identifier
1942514971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 101998
- Practice address
- 4310 E Indian School Rd
Phoenix, AZ 85018-5326 - Phone
- (602) 381-2000
- NPI assigned
- Aug 2, 2010
- Last updated
- Apr 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D010998 | AZ | |
| Dentist | 122300000X | 1340 | AK | |
| Dentist | 122300000X | 101998 | AZ | Primary |
Addresses
Primary practice location
4310 E Indian School Rd
Phoenix, AZ 85018-5326
Mailing address
4310 E Indian School Rd
Phoenix, AZ 85018-5326
Phone (720) 320-4767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210601000972 | AZ | Order and Referring Only - Dentist | 4082013792 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101998 | AZ | MD | Dentist |
| 1340 | AK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arcadia Modern Dentistry, LLP | Dentist | Past | Accepting new patients |
Interoperability endpoints
- evangundy26461@direct.midwestern.edu
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1942514971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 E INDIAN SCHOOL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850185326",
"telephone_number": "720-320-4767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 E INDIAN SCHOOL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850185326",
"telephone_number": "602-381-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN GUNDY",
"first_name": "ERIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-02",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D010998",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1340",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "101998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.