Paul N Cardon DDS LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PAUL N CARDON DDS LLC

Doing business as

Stadium Dental Center

Practice address

757 W Stadium Blvd Ste B
Jefferson City, MO 65109-4786

Phone

(573) 636-5522

Fax

(573) 636-3328

NPI assigned

Mar 9, 2023

Last updated

Mar 9, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Paul Nolan Cardon, DDSNPI 1083618342

Title

Owner

Phone

(573) 636-5522

Specialties & licenses 1

Addresses

Other names 1

• Stadium Dental Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Nolan Cardon, D.D.S.

  • Dentist
  • Monument, CO
  • NPI 1083618342
  NPD Authorized official
• Robert A Protzman

  • General Practice Dentistry
  • Jefferson City, MO
  • NPI 1972679470
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1184324873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 W STADIUM BLVD STE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094786",
            "telephone_number": "573-636-5522",
            "fax_number": "573-636-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 W STADIUM BLVD STE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094786",
            "telephone_number": "573-636-5522",
            "fax_number": "573-636-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL N CARDON DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "NOLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-636-5522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stadium Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patient Care Inc.
• Jeffrey P. Patrick, M.D.
• Adam Clay Patterson, MD
• Dayna Lynette Patterson, FNP
• Lyndsey Patterson, OTR/L
• Suzanne M. Pautler, M.D.
• Grace Payment, OTD, OTR/L
• Garry D Pearson, D.O.
• Thelma Lillie Peery, D.O.
• Lisa Pegg, PLPC

• Dental Clinic/Center in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.