NPIMap

Organization Active NPI

Waterman Family Dentistry

Doing business as a division of Atlantic Dental Care

  • Dentist
  • Virginia Beach, VA
National Provider Identifier
1255762092
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411099 Issued in VA
Legal business name
WATERMAN FAMILY DENTISTRY
Doing business as
a division of Atlantic Dental Care
Practice address
525 N Great Neck Rd
Virginia Beach, VA 23454-4035
Phone
(757) 340-8155
Fax
(757) 340-3919
NPI assigned
Dec 4, 2013
Organization subpart
Yes
Parent organization
ATLANTIC DENTAL CARE, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Authorized official

Name
Dr. Jennier Ross Waterman, DDS
Title
Dentist
Phone
(757) 340-8155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 0401411099 VA Primary

Addresses

Primary practice location

525 N Great Neck Rd
Virginia Beach, VA 23454-4035

Mailing address

525 N Great Neck Rd
Virginia Beach, VA 23454-4035
Phone (757) 340-8155

Other names 1

  • a division of Atlantic Dental Care Doing business as

National Provider Directory

National Provider Directory
Part of
Vernon E O'Berry Jr DDS

Locations

525 N Great Neck Rd
Virginia Beach, VA 23454
Phone (757) 340-8155

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1386115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386115200000",
    "number": "1255762092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N GREAT NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544035",
            "telephone_number": "757-340-8155",
            "fax_number": "757-340-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N GREAT NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544035",
            "telephone_number": "757-340-8155",
            "fax_number": "757-340-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERMAN FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC DENTAL CARE, PLC",
        "enumeration_date": "2013-12-04",
        "last_updated": "2013-12-04",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "JENNIER",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "757-340-8155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "a division of Atlantic Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.