NPIMap

Organization Active NPI

Neibauer Dental Care, P.C.

Doing business as Embrey Mill Dental Care

  • General Practice Dentistry
  • Stafford, VA
National Provider Identifier
1033788419
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEIBAUER DENTAL CARE, P.C.
Doing business as
Embrey Mill Dental Care
Practice address
1610 Publix Way Ste 120
Stafford, VA 22554-7783
Phone
(540) 779-0395
NPI assigned
Jun 21, 2021
Last updated
Jun 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NEIBAUER DENTAL CARE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1610 Publix Way Ste 120
Stafford, VA 22554-7783

Mailing address

1610 Publix Way Ste 120
Stafford, VA 22554-7783
Phone (540) 779-0395

Other names 1

  • Embrey Mill Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neibauer Dental Care PC30 organizations share this tax ID, including this one
Part of
Neibauer Dental Care PC

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1033788419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 PUBLIX WAY STE 120",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547783",
            "telephone_number": "540-779-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 PUBLIX WAY STE 120",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547783",
            "telephone_number": "540-779-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIBAUER DENTAL CARE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEIBAUER DENTAL CARE, P.C.",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embrey Mill Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.