Versant Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

VERSANT DENTAL PLLC

Practice address

306 Brook Park PL
Forest, VA 24551-2638

Phone

(434) 385-4499

NPI assigned

Mar 31, 2023

Last updated

Mar 31, 2023By 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

James Gregory White, DDS

Title

Ceo

Phone

(859) 533-1109

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1023713138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SPRUCE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405072109",
            "telephone_number": "859-533-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 BROOK PARK PL",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512638",
            "telephone_number": "434-385-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERSANT DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "859-533-1109",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.