NPIMap

Organization Active NPI

Riccobene & Associates CC, DDS, PC

Doing business as Legacy Dental of McKenney

  • General Practice Dentistry
  • McKenney, VA
National Provider Identifier
1154030443
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RICCOBENE & ASSOCIATES CC, DDS, PC
Doing business as
Legacy Dental of McKenney
Practice address
10806 Rives Ave
MC Kenney, VA 23872-2041
Phone
(804) 621-7631
NPI assigned
Nov 16, 2022
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Annette Marlow
Title
Credentialing Manager
Phone
(330) 994-4533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

10806 Rives Ave
MC Kenney, VA 23872-2041

Mailing address

10806 Rives Ave
MC Kenney, VA 23872-2041
Phone (804) 621-7631

Other names 1

  • Legacy Dental of McKenney Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Riccobene Associates CC DDS PC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

10806 Rives Ave
Mc Kenney, VA 23872
Phone (804) 467-5081

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1154030443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10806 RIVES AVE",
            "city": "MC KENNEY",
            "state": "VA",
            "postal_code": "238722041",
            "telephone_number": "804-621-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10806 RIVES AVE",
            "city": "MC KENNEY",
            "state": "VA",
            "postal_code": "238722041",
            "telephone_number": "804-621-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICCOBENE & ASSOCIATES CC, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "MARLOW",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "330-994-4533"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Dental of McKenney",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Legacy Dental of McKenney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McKenney, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.