Madeleine Maas

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401417867 Issued in VA

Practice address

8904 W Broad St Ste 202
Henrico, VA 23294-5826

Phone

(804) 716-5430

NPI assigned

Mar 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ideal Smile LLC

  • General Practice Dentistry
  • Henrico, VA
  • NPI 1629581715
  NPD (past)

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1235717703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 GARDEN CLUB CIR APT 306",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230597573",
            "telephone_number": "201-401-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8904 W BROAD ST STE 202",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232945826",
            "telephone_number": "804-716-5430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 New Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Perth Amboy",
            "state": "NJ",
            "postal_code": "088613685",
            "country_code": "US",
            "telephone_number": "732-442-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1945 State Route 33",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534859",
            "country_code": "US",
            "telephone_number": "732-775-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAAS",
        "first_name": "MADELEINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ming You Luo
• Erica Lurry, LCSW
• Luxottica of America Inc.
• LWM Service Facilitator
• Lindsey Ann Lyon, PT, DPT
• Maddie Decker, LLC
• Brandon Andrew Maddox, RN
• Gina Maggio, MS CCC-SLP
• Fadi Mohammad Majdalawi, DMV
• Major Addiction and Recovery House LLC

• General Practice Dentistry in Henrico, VA
• Providers in Henrico, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.