Prime Family Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PRIME FAMILY DENTISTRY, PLLC

Practice address

24805 Pinebrook Rd # 316
Chantilly, VA 20152-4126

Phone

(703) 403-1304

NPI assigned

Feb 23, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Subha C Yerabollu, DDSNPI 1982835641

Title

Dentist

Phone

(703) 403-1304

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Subha C Yerabollu, DDS

  • General Practice Dentistry
  • Chantilly, VA
  • NPI 1982835641
  NPD (past) Authorized official

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1255832234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22917 EMERALD CHASE PL",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201486446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24805 PINEBROOK RD # 316",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524126",
            "telephone_number": "703-403-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "YERABOLLU",
        "authorized_official_first_name": "SUBHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "703-403-1304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.