Active NPI
Julian William Fields IV, D.D.S.
- Dentist
- Altavista, VA
National Provider Identifier
1245383397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401008664
- Practice address
- 2180 Lynch Mill Rd
Altavista, VA 24517-1150 - Phone
- (434) 369-4702
- Fax
- (434) 369-4703
- NPI assigned
- Jan 20, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401008664 | VA | Primary |
Addresses
Primary practice location
2180 Lynch Mill Rd
Altavista, VA 24517-1150
Mailing address
2180 Lynch Mill Rd
Altavista, VA 24517-1150
Phone (434) 369-4702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108554 | Medicaid | VA |
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
- Opted out of Medicare
- Yes, effective Mar 2, 2015 through Mar 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401008664 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Julian Fields, DDS LTD | Dentist | Past | Accepting new patients |
| Julian W. Fields D.D.S., LTD. | Past | Accepting new patients |
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.
-
- Dental Clinic/Center
- Altavista, VA
- NPI 1861658726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1245383397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 LYNCH MILL RD",
"city": "ALTAVISTA",
"state": "VA",
"postal_code": "245171150",
"telephone_number": "434-369-4702",
"fax_number": "434-369-4703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 LYNCH MILL RD",
"city": "ALTAVISTA",
"state": "VA",
"postal_code": "245171150",
"telephone_number": "434-369-4702",
"fax_number": "434-369-4703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIELDS",
"first_name": "JULIAN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401008664",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108554",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altavista, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.