Charlottesville Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CHARLOTTESVILLE PEDIATRIC DENTISTRY LLC

Practice address

1620 Timberwood Blvd Ste 201
Charlottesville, VA 22911-7573

Phone

(434) 975-7336

NPI assigned

Jun 28, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Brooke Heath

Title

Office Manager

Phone

(434) 975-7336

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Taylor Smith, DDD

  • Pediatric Dentistry
  • Charlottesville, VA
  • NPI 1457884223
  NPD

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1023740180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 TIMBERWOOD BLVD STE 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117573",
            "telephone_number": "434-975-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 TIMBERWOOD BLVD STE 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117573",
            "telephone_number": "434-975-7336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Jefferson Ct Ste 101",
            "address_purpose": "LOCATION",
            "city": "Zion Crossroads",
            "state": "VA",
            "postal_code": "229429604",
            "country_code": "US",
            "telephone_number": "540-832-6657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHARLOTTESVILLE PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "HEATH",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "434-975-7336",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.