Provider Demographics
NPI:1861295768
Name:LUND DENTAL LLC
Entity type:Organization
Organization Name:LUND DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-509-0583
Mailing Address - Street 1:1214 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-1931
Mailing Address - Country:US
Mailing Address - Phone:317-509-0583
Mailing Address - Fax:
Practice Address - Street 1:4082 PENDLETON WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5224
Practice Address - Country:US
Practice Address - Phone:317-509-0583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty