NPIMap

Organization Active NPI

Center for Restorative, Cosmetic, and Implant Dentistry, PC

Doing business as A Division of Atlantic Dental Care, PLC

  • Dentist
  • Chesapeake, VA
National Provider Identifier
1235475286
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412179 Issued in VA
Legal business name
CENTER FOR RESTORATIVE, COSMETIC, AND IMPLANT DENTISTRY, PC
Doing business as
A Division of Atlantic Dental Care, PLC
Practice address
825 Battlefield Blvd S
Chesapeake, VA 23322-6607
Phone
(757) 482-2876
Fax
(757) 546-0235
NPI assigned
Dec 19, 2012
Organization subpart
Yes
Parent organization
ATLANTIC DENTAL CARE, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Authorized official

Name
David Lewis, DMD
Title
Dentist
Phone
(757) 482-2876

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401412179 VA Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401006003 VA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401411399 VA

Addresses

Primary practice location

825 Battlefield Blvd S
Chesapeake, VA 23322-6607

Mailing address

825 Battlefield Blvd S
Chesapeake, VA 23322-6607
Phone (757) 482-2876

Other names 1

  • A Division of Atlantic Dental Care, PLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
A Division of Atlantic Dental Care PLC2 organizations share this tax ID, including this one
Part of
Melvin E Cruser III DDS

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1235475286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BATTLEFIELD BLVD S",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233226607",
            "telephone_number": "757-482-2876",
            "fax_number": "757-546-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 BATTLEFIELD BLVD S",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233226607",
            "telephone_number": "757-482-2876",
            "fax_number": "757-546-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR RESTORATIVE, COSMETIC, AND IMPLANT DENTISTRY, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC DENTAL CARE, PLC",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "757-482-2876",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412179",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006003",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Division of Atlantic Dental Care, PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.