Elizabeth A Standerwick, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416925 Issued in VA

Practice address

10608 Leavells Rd
Fredericksburg, VA 22407-1256

Phone

(540) 710-6000

NPI assigned

Jun 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1023501087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 CHAMPIONS WAY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224089616",
            "telephone_number": "217-972-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10608 LEAVELLS RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224071256",
            "telephone_number": "540-710-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDERWICK",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fredericksburg, VA
• Providers in Fredericksburg, 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 Jun 9, 2021; 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.