Active NPI
Connor Dean Westersund, DMD
- General Practice Dentistry
- Brick, NJ
National Provider Identifier
1356074504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI02903800
- Practice address
- 445 Brick Blvd
Brick, NJ 08723-6048 - Phone
- (732) 477-1335
- NPI assigned
- Jul 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02903800 | NJ | Primary |
Addresses
Primary practice location
445 Brick Blvd
Brick, NJ 08723-6048
Mailing address
445 Brick Blvd Ste 307
Brick, NJ 08723-6080
Phone (732) 477-1335
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02903800 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657065600000",
"number": "1356074504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 BRICK BLVD STE 307",
"city": "BRICK",
"state": "NJ",
"postal_code": "087236080",
"telephone_number": "732-477-1335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 BRICK BLVD",
"city": "BRICK",
"state": "NJ",
"postal_code": "087236048",
"telephone_number": "732-477-1335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTERSUND",
"first_name": "CONNOR",
"middle_name": "DEAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-06",
"last_updated": "2022-07-06",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02903800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.