Basic Information
Provider Information
NPI: 1477182145
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUNDAY
FirstName: NAVKIRAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 525 E MARKET ST
Address2:  
City: AKRON
State: OH
PostalCode: 443041619
CountryCode: US
TelephoneNumber: 3303756262
FaxNumber: 3303753274
Practice Location
Address1: 525 E MARKET ST
Address2:  
City: AKRON
State: OH
PostalCode: 443041619
CountryCode: US
TelephoneNumber: 3303756262
FaxNumber: 3303753274
Other Information
ProviderEnumerationDate: 04/05/2020
LastUpdateDate: 04/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
1223G0001X2901600780MIY Dental ProvidersDentistGeneral Practice

No ID Information.


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