Active NPI
Patrina Allen
- General Practice Dentistry
- Chesapeake, VA
National Provider Identifier
1003502667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401418751
- Practice address
- 825 Battlefield Blvd S
Chesapeake, VA 23322-6607 - Phone
- (757) 482-2876
- NPI assigned
- Apr 14, 2023
- Last updated
- Jun 17, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401418751 | VA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
825 Battlefield Blvd S
Chesapeake, VA 23322-6607
Mailing address
100 Health Center Dr
Ahoskie, NC 27910-8161
Other practice location 1
560 Kempsville Rd Ste 200
Chesapeake, VA 23320-3603
Phone (757) 547-2770
Other practice location 2
100 Health Center Dr
Ahoskie, NC 27910-8161
Phone (252) 332-1904
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401418751 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Restorative, Cosmetic, and Implant Dentistry, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba A Division of Atlantic Dental Care, PLC
- Dentist
- Chesapeake, VA
- NPI 1235475286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1003502667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HEALTH CENTER DR",
"city": "AHOSKIE",
"state": "NC",
"postal_code": "279108161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 BATTLEFIELD BLVD S",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233226607",
"telephone_number": "757-482-2876"
}
],
"practiceLocations": [
{
"address_1": "560 Kempsville Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Chesapeake",
"state": "VA",
"postal_code": "233203603",
"country_code": "US",
"telephone_number": "757-547-2770",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Health Center Dr",
"address_purpose": "LOCATION",
"city": "Ahoskie",
"state": "NC",
"postal_code": "279108161",
"country_code": "US",
"telephone_number": "252-332-1904",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALLEN",
"first_name": "PATRINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-14",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401418751",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.