Individual provider Active NPI

Jessica Smith, DDS

  • General Practice Dentistry
  • Richmond, VA
National Provider Identifier
1265749196
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412969 Issued in VA
Practice address
9732 Midlothian Tpke
Richmond, VA 23235-4962
Phone
(804) 320-3683
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401412969 VA Primary

Addresses

Primary practice location

9732 Midlothian Tpke
Richmond, VA 23235-4962

Mailing address

3941 Paulhill Rd
Richmond, VA 23236-1232

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401412969VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Family Dental Current Accepting new patients
Dental Solutions General Practice Past Accepting new patients
Amir H Tavassoli DDS PLLC General Practice PastSince Nov 19, 2023 Accepting new patients

Locations

5161 Craig Rath Blvd
Midlothian, VA 23112
Phone (804) 744-9051

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1265749196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 PAULHILL RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232361232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9732 MIDLOTHIAN TPKE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354962",
            "telephone_number": "804-320-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.