John a Dudley DMD and Deider M Condon DMD LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5576 Issued in CT

Legal business name

JOHN A DUDLEY DMD AND DEIDER M CONDON DMD LLC

Practice address

172 Mt Pleasant Rd
Newtown, CT 06470

Phone

(203) 426-0045

Fax

(203) 270-1555

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

John A Dudley, DMD

Title

Owner Dentist

Phone

(203) 426-0045

Specialties & licenses 3

Addresses

Other names 1

• LLC Other name

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619061504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 MT PLEASANT RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "06470",
            "telephone_number": "203-426-0045",
            "fax_number": "203-270-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 MT PLEASANT RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "06470",
            "telephone_number": "203-426-0045",
            "fax_number": "203-270-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A DUDLEY DMD AND DEIDER M CONDON DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "203-426-0045",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5576",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8304",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "9004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kristina Rose Jamo Morais, PT, DPT
• Suhae Jang, DDS
• Aimee Jaquez, PAC
• Jeffrey P. Friedman MD
• JGB Professional Counseling, LLC
• Joshua E. Baum, DMD
• Sarah Katrulya, LCSW
• Andrea Jean Kaufmann, PA
• Anne-Marie Keegan, LICSW
• Indra Keliuotis, LCSW

• General Practice Dentistry in Newtown, CT
• Providers in Newtown, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.