Mollie Capone, DMD

Individual provider Active NPI General Practice Dentistry · Gate City, VA

NPI 1245924067 · NPPES record last updated Aug 19, 2024

Key facts

NPI
1245924067
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401419108 (VA)
Practice address
116 Ravine St Ste 101
Gate City, VA 24251-3312
Phone
(276) 386-6162
NPI assigned
Jun 5, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0401419108VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey D. Montgomery, DDS, PC General Practice Current
since Aug 25, 2024
Accepting new patients

Locations

116 Ravine St
Ste 101
Gate City, VA 24251
Phone (276) 386-6162

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12244 TN
General Practice Dentistry 1223G0001X 0401419108 VA Yes

Addresses

Primary practice location

116 Ravine St Ste 101
Gate City, VA 24251-3312

Mailing address

116 Ravine St Ste 101
Gate City, VA 24251-3312
Phone (276) 386-6162

Other practice location 1

1303 Carroll Creek Rd
Johnson City, TN 37615-4790
Phone (423) 232-0747

Other providers in Gate City, VA

All providers in Gate City, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.