NPIMap

Organization Active NPI

Upper Mattaponi Indian Tribe

Doing business as Aylett Family Dentistry

  • Dental Clinic/Center
  • Aylett, VA
National Provider Identifier
1245098391
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
UPPER MATTAPONI INDIAN TRIBE
Doing business as
Aylett Family Dentistry
Practice address
8014 Richmond Tappahannock Hwy
Aylett, VA 23009-3056
Phone
(804) 769-2015
NPI assigned
Mar 12, 2024
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
UPPER MATTAPONI INDIAN TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Steven Tupponce
Title
Director-Umit Health Services
Phone
(804) 347-4109

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

8014 Richmond Tappahannock Hwy
Aylett, VA 23009-3056

Mailing address

13476 King William Rd
King William, VA 23086-3401
Phone (804) 769-0041

Other names 1

  • Aylett Family Dentistry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210923002671 TX Part B Supplier - Clinic/Group Practice 4880091446 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aylett, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Upper Mattaponi Indian Tribe5 organizations share this tax ID, including this one
Part of
Upper Mattaponi Indian Tribe

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1245098391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13476 KING WILLIAM RD",
            "city": "KING WILLIAM",
            "state": "VA",
            "postal_code": "230863401",
            "telephone_number": "804-769-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8014 RICHMOND TAPPAHANNOCK HWY",
            "city": "AYLETT",
            "state": "VA",
            "postal_code": "230093056",
            "telephone_number": "804-769-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER MATTAPONI INDIAN TRIBE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPPER MATTAPONI INDIAN TRIBE",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "TUPPONCE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR-UMIT HEALTH SERVICES",
        "authorized_official_telephone_number": "804-347-4109"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aylett Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aylett, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.