NPIMap

Organization Active NPI

Charles S. Llewellyn III

  • Dentist
  • Virginia Beach, VA
National Provider Identifier
1053657171
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4010062461 Issued in VA
Legal business name
CHARLES S. LLEWELLYN III
Doing business as
A DIVISION OF ALANTIC DENTAL CARE
Practice address
933 First Colonial Rd
Suite 104
Virginia Beach, VA 23454-3172
Phone
(757) 428-2571
Fax
(757) 422-4236
NPI assigned
Dec 18, 2012
Organization subpart
Yes
Parent organization
ATLANTIC DENTAL CARE, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Dr. Charles Silas Llewellyn III, DDS
Title
Dentist
Phone
(757) 428-2571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 4010062461 VA Primary

Addresses

Primary practice location

933 First Colonial Rd
Suite 104
Virginia Beach, VA 23454-3172

Mailing address

933 First Colonial Rd
Suite 104
Virginia Beach, VA 23454-3172
Phone (757) 428-2571

Other names 1

  • A DIVISION OF ALANTIC DENTAL CARE Doing business as

National Provider Directory

National Provider Directory
Part of
Melvin E Cruser III DDS

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.

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1053657171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 FIRST COLONIAL RD",
            "address_2": "SUITE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543172",
            "telephone_number": "757-428-2571",
            "fax_number": "757-422-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 FIRST COLONIAL RD",
            "address_2": "SUITE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543172",
            "telephone_number": "757-428-2571",
            "fax_number": "757-422-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES S. LLEWELLYN III",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC DENTAL CARE, PLC",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "LLEWELLYN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "SILAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "757-428-2571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "4010062461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A DIVISION OF ALANTIC DENTAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.