NPIMap

Organization Active NPI

Dental Professionals of Virginia, P.C.

Doing business as Ridgefield Village Dental Care

  • General Practice Dentistry
  • Woodbridge, VA
National Provider Identifier
1063167039
Registry record updated Feb 17, 2022
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
Ridgefield Village Dental Care
Practice address
12707 Ridgefield Village Dr Ste 101
Woodbridge, VA 22193-8915
Phone
(571) 989-6570
NPI assigned
Feb 17, 2022
Last updated
Feb 17, 2022By 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 Feb 17, 2022

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 Dentistry 1223G0001X Primary

Addresses

Primary practice location

12707 Ridgefield Village Dr Ste 101
Woodbridge, VA 22193-8915

Mailing address

12707 Ridgefield Village Dr Ste 101
Woodbridge, VA 22193-8915
Phone (571) 989-6570

Other names 1

  • Ridgefield Village Dental Care 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 14

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

View all 14

Locations

12707 Ridgefield Village Dr
Ste 101
Woodbridge, VA 22193
Phone (571) 989-6570

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 2

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": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1063167039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12707 RIDGEFIELD VILLAGE DR STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221938915",
            "telephone_number": "571-989-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12707 RIDGEFIELD VILLAGE DR STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221938915",
            "telephone_number": "571-989-6570"
        }
    ],
    "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": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "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": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgefield Village Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbridge, VA

Sources for this page

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