NPIMap

Organization Active NPI

Dental Professionals of Virginia, P.C.

Doing business as LWSS Family Dentistry - Suffolk

  • General Practice Dentistry
  • Suffolk, VA
National Provider Identifier
1053077453
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF VIRGINIA, P.C.
Doing business as
LWSS Family Dentistry - Suffolk
Practice address
210 Meadow View Blvd
Suffolk, VA 23435-3495
Phone
(757) 416-5977
NPI assigned
Nov 10, 2021
Last updated
Nov 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF VIRGINIA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordiantor
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

210 Meadow View Blvd
Suffolk, VA 23435-3495

Mailing address

210 Meadow View Blvd
Suffolk, VA 23435-3495

Other names 1

  • LWSS FAMILY DENTISTRY - SUFFOLK Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Virginia PC69 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Virginia PC

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

300 E Little Creek Rd
Norfolk, VA 23505
Phone (757) 587-6453

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1053077453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MEADOW VIEW BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MEADOW VIEW BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353495",
            "telephone_number": "757-416-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF VIRGINIA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF VIRGINIA, P.C.",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDIANTOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LWSS FAMILY DENTISTRY - SUFFOLK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.