NPIMap

Organization Active NPI

Southern Dominion Health System, Inc.

Doing business as Dinwiddie Medical Center and Family Dentistry

  • Federally Qualified Health Center (FQHC)
  • Dinwiddie, VA
National Provider Identifier
1124310446
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHERN DOMINION HEALTH SYSTEM, INC.
Doing business as
Dinwiddie Medical Center and Family Dentistry
Practice address
13855 Courthouse Road
Dinwiddie, VA 23841
Phone
(804) 469-3731
Fax
(804) 469-5307
NPI assigned
May 4, 2011
Last updated
Feb 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Authorized official

Name
Mrs. Jill W Seamans
Title
Cfo
Phone
(434) 696-2165

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Federally Qualified Health Center (FQHC) 261QF0400X VA Primary

Addresses

Primary practice location

13855 Courthouse Road
Dinwiddie, VA 23841

Mailing address

PO Box 70
Victoria, VA 23974-0070
Phone (434) 696-2165

Other names 1

  • Dinwiddie Medical Center and Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Amelia Health Care Cent4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1124310446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "VICTORIA",
            "state": "VA",
            "postal_code": "239740070",
            "telephone_number": "434-696-2165",
            "fax_number": "434-696-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13855 COURTHOUSE ROAD",
            "city": "DINWIDDIE",
            "state": "VA",
            "postal_code": "23841",
            "telephone_number": "804-469-3731",
            "fax_number": "804-469-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DOMINION HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "SEAMANS",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "434-696-2165",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dinwiddie Medical Center and Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dinwiddie, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.