DR. CHARLES EDMUND CONNELLY JR. (NPI# 1497890669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497890669 |
| Entity Type | Individual |
| Full Name | DR. CHARLES EDMUND CONNELLY JR. |
| Other Name | C EDMUND CONNELLY |
| Credential | DDS |
| Practice Address |
406 Lecompte Street Cambridge MD 21613 |
| Practice Telephone | 4102288770 |
| Practice Fax Number | 4102280598 |
| Mailing Telephone | 4102288770 |
| Mailing Fax Number | 4102280598 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4797 | MD | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CARE FIRST BCBS | 2036 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285728436 | Charles Christopher Connelly | Counselor | 55 N Clinton Ave, Trenton, NJ 08609-1011 | 2006-10-03 |
| Street Address |
406 LECOMPTE STREET |
| City | CAMBRIDGE |
| State | MD |
| Zip Code | 21613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225427289 | A Better Alternative Nursing Avency, Inc | Nursing Care | 204 Cedar Street, Canbridge, MD 21613 | 2015-01-14 |
| 1497048524 | Christina Marie Drostin | Family Medicine | 503 A Muir Street, Cambridge, MD 21613 | 2011-05-23 |
| 1841589058 | Wal-mart Stores East Lp | Technician/Technologist | 2775 Dorchester Square, Cambridge, MD 21613 | 2011-03-29 |
| 1053624452 | Gina Exantus-bernard | Pediatrics | 400 Byrn St Ste A, Cambridge, MD 21613 | 2010-07-14 |
| 1235362872 | St of Md/dhmh Dorchester Co Health Dept | Public Health or Welfare | 2475 Cambridge Bypass, Cambridge, MD 21613 | 2009-08-31 |
| 1801916622 | Alisha Foxwell Saulsbury | Social Worker | 208 Cedar St, Cambridge, MD 21613 | 2007-03-29 |
| 1114088192 | Delmarva Community Services Inc | Nursing Care | 6210 Shiloh Church Hurlock Rd, Hurlock, MD 21613 | 2006-12-13 |
| 1184782658 | Lesa M Lee | Social Worker | 403 Race Street, Cambridge, MD 21613 | 2006-12-05 |
| 1750455747 | Jenny Lynne Jarrell | Social Worker | 208 Cedar Street, Cambridge, MD 21613 | 2006-11-20 |
| 1659474310 | Revco Discount Drug Centers Inc | Pharmacy | 626 Sunburst Hwy, Cambridge, MD 21613 | 2006-09-07 |
| Find all providers in zip 21613 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968784 | Francina Alvarez Noboa | Dentist | 700 Huron Ave Apt 15m, Cambridge, MA 02138-4590 | 2020-10-01 |
| 1487207239 | George Duncan Georgiev | Dentist | 12 Holbrook Crescent, Cambridge, ONTARIO N1T 1V7 | 2019-07-22 |
| 1609435833 | Jeffrey E. Greenberg, Dmd, P.C. | Dentist | 763 Massachusetts Ave Ste 1, Cambridge, MA 02139-3329 | 2019-06-11 |
| 1720646987 | Lindsey White | Dentist | 40890 W. Hwy 6 & 34, Cambridge, NE 69022 | 2019-06-03 |
| 1619533304 | Sarah Lamecker | Dentist | 110 Opportunity Blvd S Ste A, Cambridge, MN 55008-2222 | 2019-05-17 |
| 1700342268 | Avalon Dental LLC | Dentist | 160 Cambridge St Unit H, Cambridge, MA 02141-1819 | 2019-02-20 |
| 1740637941 | Lissa Cisneros | Dentist | 135 Opportunity Blvd S, Cambridge, MN 55008-1238 | 2016-05-17 |
| 1114292000 | Two Rivers Family & Cosmetic Dentistry | Dentist | 90 S Superior, Cambridge, ID 83610 | 2012-03-12 |
| 1144503715 | Jaime Lyn Klebig | Dentist | N4220 Woodcrest Ln., Cambridge, WI 53523 | 2011-09-21 |
| 1366771792 | Archana Srinivasan | Dentist | 1 Court Ln, Unit 502, Cambridge, MD 21613-1883 | 2009-12-14 |
| Find all providers in CAMBRIDGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.