Collinsville Dental Associates, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

COLLINSVILLE DENTAL ASSOCIATES, PC

Practice address

4940 Kings Mountain Rd
Collinsville, VA 24078-1812

Phone

(276) 634-1494

NPI assigned

Oct 9, 2019

Last updated

Oct 9, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Dillon Payne

Title

Administrator

Phone

(434) 548-4305

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas John Forte, DMD

  • Dentist
  • Collinsville, VA
  • NPI 1306680046
  NPD (past)
• Bryan Lopez Gutierrez, DMD

  • Dentist
  • Collinsville, VA
  • NPI 1750125852
  NPD (past)
• Christopher Adam Payne, D.D.S.

  • General Practice Dentistry
  • Danville, VA
  • NPI 1770583106
  NPD (past)

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1013559327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5003 COBBLESTONE DRIVE",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245405255",
            "telephone_number": "434-548-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 KINGS MOUNTAIN RD",
            "city": "COLLINSVILLE",
            "state": "VA",
            "postal_code": "240781812",
            "telephone_number": "276-634-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLINSVILLE DENTAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "DILLON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "434-548-4305"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Argueta Castro, MS, BCBA, LBA, IBA
• Ronald E Bennett, RPH
• Walter Betton, O.D.
• Erica Jill Bobb, OD
• Care & Compassion LLC
• Confident Care LLC
• Claudia Carol Jade Cooke
• Linnieanne Daniel, LCSW
• Allyson C Dillard
• Disability Health Supplies Inc

• General Practice Dentistry in Collinsville, VA
• Providers in Collinsville, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.