NPIMap

Organization Active NPI

Branch Dental Clinic Courthouse Bay

  • Dental Clinic/Center
  • Camp Lejeune, NC
National Provider Identifier
1700392909
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BRANCH DENTAL CLINIC COURTHOUSE BAY
Practice address
54 Poe Rd
Camp Lejeune, NC 28542-0046
Phone
(910) 450-4233
NPI assigned
Dec 26, 2017
Organization subpart
Yes
Parent organization
NAVAL MEDICAL CENTER CAMP LEJEUNEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Authorized official

Name
William M Condon
Title
Bumed Ubo
Phone
(240) 401-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

54 Poe Rd
Camp Lejeune, NC 28542-0046

Mailing address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic McAs New River25 organizations share this tax ID, including this one
Part of
Branch Medical Clinic McAs New River

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

54 Poe Rd
Camp Lejeune, NC 28542
Phone (910) 450-4233

NPI Registry JSON

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514246400000",
    "number": "1700392909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 POE RD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420046",
            "telephone_number": "910-450-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH DENTAL CLINIC COURTHOUSE BAY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL MEDICAL CENTER CAMP LEJEUNE",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUMED UBO",
        "authorized_official_telephone_number": "240-401-3643"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; 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.