Provider Demographics
NPI:1356361471
Name:DUNN, RICHARD MILLER (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MILLER
Last Name:DUNN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 W. SR 434
Mailing Address - Street 2:SUITE 1011
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4878
Mailing Address - Country:US
Mailing Address - Phone:407-862-1870
Mailing Address - Fax:407-682-7004
Practice Address - Street 1:2639 W STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4878
Practice Address - Country:US
Practice Address - Phone:407-862-1870
Practice Address - Fax:407-682-7004
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN67761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL553680OtherUNITED CONCORDIA PROVIDER
FL9006776OtherDELTA DENTAL PROVIDER #
FL27-3226904OtherWORKS UNDER TID #
FL86838OtherBLUE CROSS BLUE SHEILD #