Provider Demographics
NPI:1215932595
Name:DUNBAR, KIM I (DDS)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:I
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1316
Mailing Address - Country:US
Mailing Address - Phone:317-774-0000
Mailing Address - Fax:317-770-8168
Practice Address - Street 1:504 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1316
Practice Address - Country:US
Practice Address - Phone:317-774-0000
Practice Address - Fax:317-770-8168
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
IN12009172A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice