Active NPI
Bruce C Dundon, MD
- Dermatology Physician
- Virginia Beach, VA
National Provider Identifier
1558540708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 0101026335
- Practice address
- 1020 Independence Blvd
Ste 312 Haygood Medical Center
Virginia Beach, VA 23455 - Phone
- (757) 460-1124
- Fax
- (757) 460-0359
- NPI assigned
- Oct 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 0101026335 | VA | Primary |
| Specialist | 174400000X | 026335 | VA |
Addresses
Primary practice location
1020 Independence Blvd
Ste 312 Haygood Medical Center
Virginia Beach, VA 23455
Mailing address
1020 Independence Blvd
Ste 312 Haygood Medical Center
Virginia Beach, VA 23455
Phone (757) 460-1124
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026335 | VA | MD | Specialist |
| 0101026335 | VA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1558540708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 INDEPENDENCE BLVD",
"address_2": "STE 312 HAYGOOD MEDICAL CENTER",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23455",
"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 BLVD",
"address_2": "STE 312 HAYGOOD MEDICAL CENTER",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23455",
"telephone_number": "757-460-1124",
"fax_number": "757-460-0359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNDON",
"first_name": "BRUCE",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-24",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "VA",
"license": "0101026335",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "026335",
"primary": false
}
],
"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 Nov 8, 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.