Provider Demographics
NPI:1316067309
Name:LUNDY, MEGAN JOANN (RDH)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:JOANN
Last Name:LUNDY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 SANDY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6423
Mailing Address - Country:US
Mailing Address - Phone:804-559-2375
Mailing Address - Fax:
Practice Address - Street 1:5417 SANDY VALLEY RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-6423
Practice Address - Country:US
Practice Address - Phone:804-559-2375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402203967124Q00000X
NY024473124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist