Provider Demographics
NPI:1841510963
Name:BUNCH, JASON K (DDS, MS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:K
Last Name:BUNCH
Suffix:
Gender:M
Credentials:DDS, MS
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14555 HAZEL DELL PKWY
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-7000
Mailing Address - Country:US
Mailing Address - Phone:317-815-9310
Mailing Address - Fax:317-815-8399
Practice Address - Street 1:14555 HAZEL DELL PKWY
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-7000
Practice Address - Country:US
Practice Address - Phone:317-815-9310
Practice Address - Fax:317-815-8399
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010651A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics