NPIMap

Organization Active NPI

Dental Professionals of Virginia, P.C.

  • General Practice Dentistry
  • Suffolk, VA
National Provider Identifier
1073901161
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF VIRGINIA, P.C.
Practice address
6255 College Dr
Suite E
Suffolk, VA 23435-2768
Phone
(757) 663-5716
NPI assigned
Dec 26, 2014
Organization subpart
Yes
Parent organization
SUFFOLK COMPLETE DENTAL CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Authorized official

Name
Carmen Woods
Title
Insurance
Phone
(217) 540-5141

Specialties & licenses 1

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

Addresses

Primary practice location

6255 College Dr
Suite E
Suffolk, VA 23435-2768

Mailing address

6225 College Dr
Suite E
Suffolk, VA 23435-2768
Phone (757) 663-5716

Other names 1

  • Suffolk Complete Dental Care Doing business as

National Provider Directory

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

Organizations with this tax ID in the same state 15

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

View all 15

Locations

6255 College Dr
Ste E
Suffolk, VA 23435
Phone (757) 663-5716

6225 College Dr
Ste E
Suffolk, VA 23435

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1073901161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 COLLEGE DR",
            "address_2": "SUITE E",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352768",
            "telephone_number": "757-663-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 COLLEGE DR",
            "address_2": "SUITE E",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352768",
            "telephone_number": "757-663-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF VIRGINIA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUFFOLK COMPLETE DENTAL CARE",
        "enumeration_date": "2014-12-26",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "217-540-5141"
    },
    "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": "Suffolk Complete Dental Care",
            "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 Feb 10, 2015; 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.