Provider Demographics
NPI:1336235951
Name:DUNN, JEFFREY
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BRADBURY DR SE STE 116
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4310
Mailing Address - Country:US
Mailing Address - Phone:505-272-1476
Mailing Address - Fax:
Practice Address - Street 1:2600 MARBLE AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2058
Practice Address - Country:US
Practice Address - Phone:505-272-2800
Practice Address - Fax:505-272-8692
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2007-05922084F0202X, 2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
010003756 00OtherAMERICHOICE
476290AVUMedicare PIN
P1308548OtherOXFORD HEALTH PLAN
NJ6017207Medicaid
1096710OtherHORIZON NJ HEALTH
4637848OtherAETNA US-HEALTHCARE
0681968000OtherAMERIHEALTH, HMO, KEYSTONE, IBC
476290OtherHORIZON BLUE CROSS BLUE SHIELD NJ
E61357Medicare UPIN
001665115OtherAMERIHEALTHPPO
1126067OtherUNITED HEALTH CARE
3K6036OtherHEALTHNET
24056OtherUNIVERSITY HEALTH PLAN