NPIMap

Organization Active NPI

Cardinal Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Glen Allen, VA
National Provider Identifier
1154948289
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CARDINAL PEDIATRIC DENTISTRY PLLC
Practice address
11551 Nuckols Rd Ste H
Glen Allen, VA 23059-5565
Phone
(804) 495-8750
Fax
(804) 495-8751
NPI assigned
Jul 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Dr. Helen Bono, DDSNPI 1740600816
Title
Owner
Phone
(804) 495-8750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

11551 Nuckols Rd Ste H
Glen Allen, VA 23059-5565

Mailing address

11105 Bothwell St
Henrico, VA 23233-2262
Phone (804) 837-7585

National Provider Directory

National Provider Directory

Locations

11551 Nuckols Rd
Ste H
Glen Allen, VA 23059
Phone (804) 495-8750

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1154948289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11105 BOTHWELL ST",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232332262",
            "telephone_number": "804-837-7585",
            "fax_number": "804-495-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD STE H",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "804-495-8750",
            "fax_number": "804-495-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "BONO",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-495-8750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.