Reynaldo Lorenzo Pella

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401417388 Issued in VA

Practice address

4625 Virginia Beach Blvd
Virginia Beach, VA 23462-6795

Phone

(757) 807-2137

NPI assigned

Apr 1, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Aspen Dental of Virginia PC

  • General Practice Dentistry
  • Virginia Beach, VA
  • NPI 1346720661
  NPD (past)

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1265060313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626795",
            "telephone_number": "757-807-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLA",
        "first_name": "REYNALDO",
        "middle_name": "LORENZO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417388",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Peery
• Emily Rose Peirce
• Jorge Pelaez, DMD
• Sujey Rangel Pelikan, BCBA, LBA
• Jennifer Pella, DMD
• Aimee M Pelletier
• Erica R Pelletier, MD
• Judith Peltz, MPT
• Pembroke Chiropractic, P.C.
• Pembroke Counseling Services

• General Practice Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.