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DERMATOLOGY ASSOCIATES OF SOUTHEASTERN CONNECTICUT, P.C.
NPI 1346306289
Dermatology in New London, CT

Active since December 28, 2006CLIA 07D0095306 · Microscopy
425 MONTAUK AVE, NEW LONDON, CT 06320(860) 442-1346(860) 444-6208 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dermatology Associates Of Southeastern Connecticut, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERMATOLOGY ASSOCIATES OF SOUTHEASTERN CONNECTICUT, P.C. (NPI 1346306289) is a healthcare organization registered as a dermatology in New London, Connecticut and active in the NPI registry since December 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists John Christopher Wiles, President, as its authorized official.

NPPES Registry Identity

NPI1346306289
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY ASSOCIATES OF SOUTHEASTERN CONNECTICUT, P.C.
Location Address425 MONTAUK AVENew London, CT 06320-4642
Mailing Address425 Montauk AveNew London, CT 06320-4642 · (860) 442-1346 · Fax (860) 444-6208
Phone(860) 442-1346
Fax(860) 444-6208
Organization SubpartNo
Authorized OfficialJohn Christopher WilesPresident · (806) 442-1346
Enumeration DateDecember 28, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1346306289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
425 MONTAUK AVE, New London, CT 06320
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Other Identifiers 1

Medicaid4090841CT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 07D0095306

Dermatology Associates Of SE Ct PC · Waterford, CT
Active · expires Aug 31, 2026
CLIA Number07D0095306
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMaryann D. Bentz MD
Laboratory Phone(860) 442-1346
Laboratory LocationDermatology Associates Of SE Ct PC914 Hartford Tpke, Ste 103, Waterford, CT 06385
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HENRY S AMDUR MD LLC
Obstetrics & Gynecology
425 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0383
DR. HENRY STEVEN AMDUR M.D.
Obstetrics & Gynecology
425 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0383
INGRID M. H. FEDER MD LLC
Family Medicine
425 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dermatology Associates Of Southeastern Connecticut, P.C.'s NPI number?

The NPI number for Dermatology Associates Of Southeastern Connecticut, P.C. is 1346306289. It was assigned to this organization in the NPPES registry on December 28, 2006.

Where is Dermatology Associates Of Southeastern Connecticut, P.C. located?

Dermatology Associates Of Southeastern Connecticut, P.C. is located at 425 Montauk Ave, New London, CT 06320. The listed phone number is (860) 442-1346.

What is Dermatology Associates Of Southeastern Connecticut, P.C.'s specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Dermatology Associates Of Southeastern Connecticut, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 07D0095306) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermatology Associates Of Southeastern Connecticut, P.C. accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Dermatology Associates Of Southeastern Connecticut, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dermatology Associates Of Southeastern Connecticut, P.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.