Organization Active NPI

Bruce C Dundon MD LTD

  • Dermatology Physician
  • Virginia Beach, VA
National Provider Identifier
1366423212
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101026335 Issued in VA
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

Updated by the provider on Oct 17, 2007

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)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.