NPIMap

Organization Active NPI

Tremont Road Dental Super, P.C.

  • General Practice Dentistry
  • Colonial Heights, VA
National Provider Identifier
1255418331
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TREMONT ROAD DENTAL SUPER, P.C.
Practice address
400C Southpark Blvd
Colonial Heights, VA 23834-2974
Phone
(678) 904-5665
Fax
(678) 904-5669
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Gail Darden
Title
Manager of Credentialing
Phone
(770) 916-8143

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

400C Southpark Blvd
Colonial Heights, VA 23834-2974

Mailing address

210 Interstate North Pkwy SE Ste 300
Atlanta, GA 30339-2233
Phone (770) 916-9000

Other names 1

  • Spencer Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spencer Dental18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

400C Southpark Blvd
Colonial Heights, VA 23834
Phone (800) 904-5665

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1255418331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 INTERSTATE NORTH PKWY SE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392233",
            "telephone_number": "770-916-9000",
            "fax_number": "678-247-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400C SOUTHPARK BLVD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342974",
            "telephone_number": "678-904-5665",
            "fax_number": "678-904-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREMONT ROAD DENTAL SUPER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "DARDEN",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "MANAGER OF CREDENTIALING",
        "authorized_official_telephone_number": "770-916-8143"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spencer Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.