Riverside Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RIVERSIDE DENTAL, PLLC

Practice address

3400 S Clark St Ste 105
Arlington, VA 22202-4050

Phone

(703) 740-8978

Fax

(571) 464-6588

NPI assigned

Jan 16, 2022

Organization subpart

No

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

Authorized official

Name

Shutong Hartsell, DMD

Title

Owner

Phone

(703) 740-8978

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Shutong Zhan Akmal, DMD

  • General Practice Dentistry
  • Arlington, VA
  • NPI 1851813430
  NPD

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

{
    "created_epoch": "1642291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642291200000",
    "number": "1093466583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 FOXCROFT RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223071103",
            "telephone_number": "828-719-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S CLARK ST STE 105",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222024050",
            "telephone_number": "703-740-8978",
            "fax_number": "571-464-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-16",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "HARTSELL",
        "authorized_official_first_name": "SHUTONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-740-8978",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyzaida Ivette Rivera-Bauer, PH.D.
• Carla Alecxandra Rivera, SLP
• Devora R Rivera
• Jose Daniel Rivera, M.D.
• Michelle A Rivera, MD
• Syed Rizvi
• RM Steadman PSYD PLLC
• Marcella Elizabeth Roach, PA-C
• Dianne W Robbins, PTA
• Katelyn Roberts, RN

• General Practice Dentistry in Arlington, VA
• Providers in Arlington, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.