Individual provider Active NPI

James Marion Culberson, D.M.D., M.S.

  • Periodontics
  • Fredericksburg, VA
National Provider Identifier
1215085568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401007102 Issued in VA
Practice address
12104 Sheraton Hills Dr
Fredericksburg, VA 22407-6748
Phone
(540) 548-2605
Fax
(540) 548-2606
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401007102 VA Primary

Addresses

Primary practice location

12104 Sheraton Hills Dr
Fredericksburg, VA 22407-6748

Mailing address

32299 Deep Meadow LN
Locust Grove, VA 22508-2953
Phone (540) 854-7390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 1, 2012 through Aug 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0401007102VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Dentist and Implant Center, Inc. PastSince Oct 6, 2024 Accepting new patients

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215085568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32299 DEEP MEADOW LN",
            "city": "LOCUST GROVE",
            "state": "VA",
            "postal_code": "225082953",
            "telephone_number": "540-854-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12104 SHERATON HILLS DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076748",
            "telephone_number": "540-548-2605",
            "fax_number": "540-548-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERSON",
        "first_name": "JAMES",
        "middle_name": "MARION",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401007102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.