Individual provider Active NPI

Magarette Weatherwax, D.D.S

  • Dentist
  • Crozet, VA
National Provider Identifier
1225318249
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413300 Issued in VA
Practice address
5690 Three Notch D Rd Ste 100
Crozet, VA 22932-3173
Phone
(434) 823-4080
NPI assigned
Aug 22, 2011
Last updated
Feb 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413300 VA Primary

Addresses

Primary practice location

5690 Three Notch D Rd Ste 100
Crozet, VA 22932-3173

Mailing address

5690 Three Notch D Rd Ste 100
Crozet, VA 22932-3173
Phone (434) 823-4080

Other names 1

  • Magarette Le Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20150701000250 DC Order and Referring Only - DentistPractitioner - Dentist 1759693971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401413300VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
James W Willis DDS PLC Dentist CurrentSince Nov 6, 2022 Accepting new patients
Neibauer Dental Care, PC Dentist PastSince Aug 1, 2020 Accepting new patients

Locations

5690 Three Notch D Rd
Ste 100
Crozet, VA 22932
Phone (434) 823-1044

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1225318249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 THREE NOTCH D RD STE 100",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323173",
            "telephone_number": "434-823-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5690 THREE NOTCH D RD STE 100",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323173",
            "telephone_number": "434-823-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERWAX",
        "first_name": "MAGARETTE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGARETTE",
            "last_name": "LE",
            "credential": "D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crozet, VA

Sources for this page

Verify at the official NPI Registry.