NPIMap

Organization Active NPI

Family Dental of Virginia, LLC

  • General Practice Dentistry
  • Richmond, VA
National Provider Identifier
1124392451
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTAL OF VIRGINIA, LLC
Practice address
3904 Hull Street Rd
Suite a
Richmond, VA 23224-1714
Phone
(804) 233-0007
NPI assigned
Mar 5, 2012
Last updated
Feb 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Chloe Decoster
Title
Senior Manager
Phone
(312) 274-4529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3904 Hull Street Rd
Suite a
Richmond, VA 23224-1714

Mailing address

3904 Hull Street Rd
Suite a
Richmond, VA 23224-1714
Phone (804) 233-0007

National Provider Directory

National Provider Directory
Tax ID family
Family Dental of Virginia LLC4 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.

Locations

3904 Hull St Rd
Ste A
Richmond, VA 23224
Phone (804) 233-0007

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1124392451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 HULL STREET RD",
            "address_2": "SUITE A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232241714",
            "telephone_number": "804-233-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 HULL STREET RD",
            "address_2": "SUITE A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232241714",
            "telephone_number": "804-233-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL OF VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "DECOSTER",
        "authorized_official_first_name": "CHLOE",
        "authorized_official_title_or_position": "SENIOR MANAGER",
        "authorized_official_telephone_number": "312-274-4529"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.