Individual provider Active NPI

Donald J Campbell

  • General Practice Dentistry
  • Gainesville, VA
National Provider Identifier
1093724502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401008476 Issued in VA
Practice address
7521 Virginia Oaks Dr Ste 230
Gainesville, VA 20155-3831
Phone
(703) 754-7151
Fax
(703) 754-1784
NPI assigned
Aug 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401008476 VA Primary

Addresses

Primary practice location

7521 Virginia Oaks Dr Ste 230
Gainesville, VA 20155-3831

Mailing address

13081 Dovetree CT
Manassas, VA 20112-4664
Phone (703) 794-0163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000920 VA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7719145853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401008476VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093724502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13081 DOVETREE CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201124664",
            "telephone_number": "703-794-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7521 VIRGINIA OAKS DR STE 230",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553831",
            "telephone_number": "703-754-7151",
            "fax_number": "703-754-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

Verify at the official NPI Registry.