Individual provider Active NPI

F. Lee Angus Jr., DDS

  • Dentist
  • Midlothian, VA
National Provider Identifier
1093904419
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
410960 Issued in VA
Practice address
2400 Pagehurst Dr
Midlothian, VA 23113-6411
Phone
(804) 794-6893
Fax
(804) 379-7679
NPI assigned
Oct 22, 2007
Last updated
Apr 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 410960 VA Primary

Addresses

Primary practice location

2400 Pagehurst Dr
Midlothian, VA 23113-6411

Mailing address

11301 Polo PL Ste C
Midlothian, VA 23113-4803
Phone (804) 379-9399

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
I20150820012204 VA Order and Referring Only - DentistPractitioner - Dentist 6709191661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
410960VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
F. Lee Angus Jr. DDS CurrentSince May 1, 2022 Accepting new patients
Rebecca Angus DDS and F Lee Angus Jr DDS PLLC Past Accepting new patients
Angus Dentistry Past Accepting new patients

Locations

11301 Polo Pl
Ste C
Midlothian, VA 23113
Phone (804) 379-9399

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1093904419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 POLO PL STE C",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231134803",
            "telephone_number": "804-379-9399",
            "fax_number": "804-798-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PAGEHURST DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136411",
            "telephone_number": "804-794-6893",
            "fax_number": "804-379-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGUS",
        "first_name": "F.",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "410960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.