NPIMap

Organization Active NPI

NRV Oral & Maxillofacial Surgery, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Blacksburg, VA
National Provider Identifier
1013097195
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
NRV ORAL & MAXILLOFACIAL SURGERY, LTD
Practice address
100 Professional Park Dr SE
Suite 1
Blacksburg, VA 24060-6665
Phone
(540) 951-8777
Fax
(540) 951-9642
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Dr. Clinton W Howard III, DMDNPI 1073504882
Title
Surgeon
Phone
(540) 951-8777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

100 Professional Park Dr SE
Suite 1
Blacksburg, VA 24060-6665

Mailing address

100 Professional Park Dr SE
Suite 1
Blacksburg, VA 24060-6665
Phone (540) 951-8777

Other identifiers 3

IdentifierTypeStateIssuer
8017808MedicaidVA
8010285MedicaidVA
8000697MedicaidVA

National Provider Directory

National Provider Directory

Locations

100 Professional Park Dr SE
Ste 1
Blacksburg, VA 24060
Phone (540) 951-8777

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1013097195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PARK DR SE",
            "address_2": "SUITE 1",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606665",
            "telephone_number": "540-951-8777",
            "fax_number": "540-951-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PARK DR SE",
            "address_2": "SUITE 1",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606665",
            "telephone_number": "540-951-8777",
            "fax_number": "540-951-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRV ORAL & MAXILLOFACIAL SURGERY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "540-951-8777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8017808",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8010285",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000697",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.