Organization Active NPI

River Run Dental of Virginia Beach PLLC

  • General Practice Dentistry
  • Virginia Beach, VA
National Provider Identifier
1063374387
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RIVER RUN DENTAL OF VIRGINIA BEACH PLLC
Practice address
1101 First Colonial Rd Ste 101
Virginia Beach, VA 23454-2409
Phone
(571) 659-5954
NPI assigned
Nov 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Kim Davis
Title
RCM Director
Phone
(703) 568-5773

Specialties & licenses 1

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

Addresses

Primary practice location

1101 First Colonial Rd Ste 101
Virginia Beach, VA 23454-2409

Mailing address

1101 First Colonial Rd Ste 101
Virginia Beach, VA 23454-2409

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1063374387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409",
            "telephone_number": "571-659-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RUN DENTAL OF VIRGINIA BEACH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "RCM DIRECTOR",
        "authorized_official_telephone_number": "703-568-5773"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 25, 2025; 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.