Individual provider Active NPI

David John Connelly, D.D.S.

  • Endodontics
  • Charlottesville, VA
National Provider Identifier
1205033644
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0401411609 Issued in VA
Practice address
2701 Hydraulic Rd Ste 103
Charlottesville, VA 22901-9059
Phone
(434) 973-4301
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 0401411609 VA Primary

Addresses

Primary practice location

2701 Hydraulic Rd Ste 103
Charlottesville, VA 22901-9059

Mailing address

2701 Hydraulic Rd Ste 103
Charlottesville, VA 22901-9059
Phone (434) 409-9192

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-1774

Other practice location 2

1222 Jefferson Park Ave
Charlottesville, VA 22903-3410
Phone (434) 924-1774

Other names 1

  • Dr. David John Coon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815000181 VA Practitioner - EndodonticsPractitioner - Dentist 2062716509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndodonticsAlso: Dentist
Education
Texas a & M University System, HSC, College of Medicine, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 5, 2025 Accepting new patients

Locations

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1222 Jefferson Park Ave
Fl 2
Charlottesville, VA 22903
Phone (434) 924-1774

1222 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-1774

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

Interoperability endpoints

  • Direct secure messaging: dconnelly685011@direct.healthsystem.virginia.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1205033644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HYDRAULIC RD STE 103",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229019059",
            "telephone_number": "434-409-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HYDRAULIC RD STE 103",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229019059",
            "telephone_number": "434-973-4301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-1774",
            "fax_number": "434-243-6378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1222 Jefferson Park Ave",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229033410",
            "country_code": "US",
            "telephone_number": "434-924-1774",
            "fax_number": "434-982-6417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401411609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "COON",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.