NPIMap

Individual provider Active NPI

Nicholas Peter Kondon, DMD

  • Prosthodontics
  • Concord, MA
National Provider Identifier
1215959234
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
17715 Issued in MA
Practice address
290 Baker Avenue
Suite S203
Concord, MA 01742
Phone
(978) 369-9090
Fax
(978) 371-2936
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 17715 MA Primary

Addresses

Primary practice location

290 Baker Avenue
Suite S203
Concord, MA 01742

Mailing address

290 Baker Avenue
Suite S203
Concord, MA 01742
Phone (978) 369-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17715MAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas P. Kondon DMD, PC Prosthodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1215959234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 BAKER AVENUE",
            "address_2": "SUITE S203",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-369-9090",
            "fax_number": "978-371-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 BAKER AVENUE",
            "address_2": "SUITE S203",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-369-9090",
            "fax_number": "978-371-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDON",
        "first_name": "NICHOLAS",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "17715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.