David R. Tebbenkamp DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401004941 Issued in VA

Legal business name

DAVID R. TEBBENKAMP DDS PC

Practice address

21788 Azen Rd
Damascus, VA 24236-4236

Phone

(276) 388-3511

Fax

(276) 388-3163

NPI assigned

Jul 24, 2007

Last updated

Jul 24, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David Ray Tebbenkamp, DDS

Title

Dentist/President

Phone

(276) 388-3511

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1114127537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21788 AZEN RD",
            "city": "DAMASCUS",
            "state": "VA",
            "postal_code": "242364236",
            "telephone_number": "276-388-3511",
            "fax_number": "276-388-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21788 AZEN RD",
            "city": "DAMASCUS",
            "state": "VA",
            "postal_code": "242364236",
            "telephone_number": "276-388-3511",
            "fax_number": "276-388-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R. TEBBENKAMP DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "TEBBENKAMP",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "276-388-3511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401004941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-BLUE CROSS BLUE SH",
            "identifier": "228633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Burner Barnett, LCSW
• Terry Carson Belisle
• Lacy Clay, PHARM.D.
• Damascus Volunteer Rescue Squad, Inc
• Rebecca Hill Dearmond II
• Thomas Raymond Foltz Jr., D.C.
• H2 Rehabilitation Services of Virginia, LLC (H2 Health)
• K VA T Food Stores Inc (Food City Pharmacy)
• Laurel Family Drug Inc (Laurel Family Drug)

• General Practice Dentistry in Damascus, VA
• Providers in Damascus, 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 Jul 24, 2007; 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.