Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1184769739 Individual Practitioner Female Practitioner

Dr. Shandra Lolita Bundy-Smith , DDS

Dentist - General Practice • Harvey, IL

Professional Overview & Biography Verified Profile Summary

Dr. Shandra Bundy-Smith, DDS is a registered healthcare professional specializing in Dentist - General Practice in Harvey, IL. Practice services are available at 31 W 155TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

31 W 155th St

Harvey, IL 604263556

Telephone 7085965177
Associated Practice Facility / Clinic
🏢 J And M Pharmacy Inc Facility NPI 1386686970

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Harvey, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
4 Specialists

Practicing in Harvey, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-07-13
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019023785

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License IN 12013090A

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Practice Locations

713 Us Highway 41 Ste A

Schererville, IN 463751798

Phone: 2192938039

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Maira Ochoa , APN

Nurse Practitioner - Family

NPI 1003303769

Advanced Practice Nurse

Mia Webster-Cross , RN, BSN

Registered Nurse - Administrator

NPI 1013406180

Registered Nurse, Bachelor of Science in Nursing

NPI 1033353792

Doctor of Osteopathic Medicine (D.O.)

Yvette Johnson , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1043608631

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Beryl Armstrong , LCPC

Counselor - Professional

NPI 1043755697

Licensed Clinical Professional Counselor

NPI 1053020107

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location July 13, 2021

Registered at 31 W 155TH ST, HARVEY, IL 604263556 (Tel: 7085965177)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2021

Dentist (License #019023785 in IL)

📍
Updated Practice Location April 25, 2019

Registered at 713 US HIGHWAY 41 STE A, SCHERERVILLE, IN 463751798 (Tel: 2192938039)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 25, 2019

Dentist (License #12013090A in IN)

NPI Profile Active May 18, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location May 18, 2012

Registered at 31 W 155TH ST, HARVEY, IL 604263556 (Tel: 7085965177)

📍
Updated Business Mailing Address May 18, 2012

Registered at 19512 SEQUOIA AVE, LYNWOOD, IL 604116825 (Tel: 7082886295)

👤
Provider Name / Credentials Updated May 18, 2012

Recorded as SHANDRA BUNDY-SMITH, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2012

Dentist (License #019023785 in IL)

🟢
Initial NPI Registration & Enumeration February 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184769739
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 21, 2007
Last Update: July 13, 2021
Sole Proprietor: Yes

Mailing Address

19512 Sequoia Ave

Lynwood, IL 604116825

Phone: 7082886295

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.