Individual provider Active NPI

Edmond Joseph Ormond, D.D.S.

  • General Practice Dentistry
  • Potsdam, NY
National Provider Identifier
1386714749
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
036684-1 Issued in NY
Practice address
22 Depot St
Market Square Mall
Potsdam, NY 13676-1140
Phone
(315) 265-9320
Fax
(315) 265-5903
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 036684-1 NY Primary

Addresses

Primary practice location

22 Depot St
Market Square Mall
Potsdam, NY 13676-1140

Mailing address

22 Depot St
Market Square Mall
Potsdam, NY 13676-1140
Phone (315) 265-9320

Other identifiers 1

IdentifierTypeStateIssuer
01391533MedicaidNY

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
036684-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386714749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 DEPOT ST",
            "address_2": "MARKET SQUARE MALL",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761140",
            "telephone_number": "315-265-9320",
            "fax_number": "315-265-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 DEPOT ST",
            "address_2": "MARKET SQUARE MALL",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761140",
            "telephone_number": "315-265-9320",
            "fax_number": "315-265-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORMOND",
        "first_name": "EDMOND",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036684-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01391533",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.