Provider Demographics
NPI:1437897659
Name:BUNDY, KALEIGH MORGAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KALEIGH
Middle Name:MORGAN
Last Name:BUNDY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KALEIGH
Other - Middle Name:MORGAN
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:234 PEREGRINE WAY
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-2556
Mailing Address - Country:US
Mailing Address - Phone:318-464-0475
Mailing Address - Fax:
Practice Address - Street 1:116 HOMER RD
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-2732
Practice Address - Country:US
Practice Address - Phone:318-377-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7302122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7302OtherSTATE LICENSE