Red Mill Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

RED MILL PEDIATRIC DENTISTRY, PLLC

Practice address

2336 Elson Green Ave Ste 101
Virginia Beach, VA 23456-6939

Phone

(757) 301-2064

NPI assigned

Oct 4, 2016

Last updated

Oct 10, 2024By 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

Grace O Davis

Title

Business Administrator

Phone

(757) 369-1754

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1023568995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 KILN CREEK PKWY STE P",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236935648",
            "telephone_number": "757-369-1754",
            "fax_number": "757-234-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 ELSON GREEN AVE STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234566939",
            "telephone_number": "757-301-2064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2033 Fisher Arch",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "23456",
            "country_code": "US",
            "telephone_number": "757-224-3004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RED MILL PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "757-369-1754"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Red Mill Chiropractic LLC (Commonwealth Chiropractic and Physical Therapy)
• Samantha Redd
• Joyce S Redding
• Deepika R Reddy
• Venkat Manoranjan Reddy, M.D.
• Deborah D Redmond, CSA, MSA, RSA, F-OS

• Pediatric Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.