The Nelson Dental Practice PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

0401007907 Issued in VA

Legal business name

THE NELSON DENTAL PRACTICE PC

Practice address

9216 Centreville Rd
Manassas, VA 20110-5131

Phone

(703) 361-2141

Fax

(703) 393-7391

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles Howell Nelson III, DDS

Title

Dentist

Phone

(703) 361-2141

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1164436804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9216 CENTREVILLE RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105131",
            "telephone_number": "703-361-2141",
            "fax_number": "703-393-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9216 CENTREVILLE RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105131",
            "telephone_number": "703-361-2141",
            "fax_number": "703-393-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NELSON DENTAL PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HOWELL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-361-2141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "VA",
            "license": "0401007907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Manassas, VA
• Providers in Manassas, VA by specialty
• Customized Equipment (DME) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.