Active NPI
Bruce C Dundon MD LTD
- Dermatology Physician
- Virginia Beach, VA
National Provider Identifier
1366423212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 0101026335
- Legal business name
- BRUCE C DUNDON MD LTD
- Practice address
- 1020 Independence Boulevard
Suite 312
Virginia Beach, VA 23455-5503 - Phone
- (757) 460-1124
- Fax
- (757) 460-0359
- NPI assigned
- Nov 8, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bruce Carroll Dundon, MD
- Title
- President
- Phone
- (757) 460-1124
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 0101026335 | VA | Primary |
Addresses
Primary practice location
1020 Independence Boulevard
Suite 312
Virginia Beach, VA 23455-5503
Mailing address
1020 Independence Boulevard
Suite 312
Virginia Beach, VA 23455-5503
Phone (757) 460-1124
National Provider Directory
National Provider DirectoryLocations
1020 Independence Blvd
Ste 312
Virginia Beach, VA 23455
Phone (757) 460-1124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1192579200000",
"number": "1366423212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 INDEPENDENCE BOULEVARD",
"address_2": "SUITE 312",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234555503",
"telephone_number": "757-460-1124",
"fax_number": "757-460-0359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 INDEPENDENCE BOULEVARD",
"address_2": "SUITE 312",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234555503",
"telephone_number": "757-460-1124",
"fax_number": "757-460-0359"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRUCE C DUNDON MD LTD",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-08",
"last_updated": "2007-10-17",
"status": "A",
"authorized_official_last_name": "DUNDON",
"authorized_official_first_name": "BRUCE",
"authorized_official_middle_name": "CARROLL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "757-460-1124",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "VA",
"license": "0101026335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.