NPIMap

Organization Active NPI

Dynamic Dental Health Associates of Virginia,PC

  • General Practice Dentistry
  • Chesapeake, VA
National Provider Identifier
1265860928
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DYNAMIC DENTAL HEALTH ASSOCIATES OF VIRGINIA,PC
Practice address
4107 Portsmouth Blvd Ste 107
Chesapeake, VA 23321-2140
Phone
(757) 488-1421
Fax
(727) 488-7333
NPI assigned
Oct 16, 2013
Organization subpart
Yes
Parent organization
DYNAMIC DENTAL HEALTH ASSOCIATES OF VIRGINIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Nancy Schiaparelli
Title
Chief Financial Officer
Phone
(727) 800-8040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4107 Portsmouth Blvd Ste 107
Chesapeake, VA 23321-2140

Mailing address

136 4TH St N Ste 201
St Petersburg, FL 33701-3889
Phone (727) 800-8026

Other identifiers 1

IdentifierTypeStateIssuer
700145001MedicaidVA

Other names 1

  • Cross Road Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dynamic Dental Health Associates of Virginiapc8 organizations share this tax ID, including this one
Part of
Dynamic Dental Health Associates of Virginiapc

Other organizations with this tax ID 7

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

Locations

4107 Portsmouth Blvd
Ste 107
Chesapeake, VA 23321
Phone (757) 488-1421

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 2

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": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1265860928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 4TH ST N STE 201",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013889",
            "telephone_number": "727-800-8026",
            "fax_number": "727-304-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 PORTSMOUTH BLVD STE 107",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233212140",
            "telephone_number": "757-488-1421",
            "fax_number": "727-488-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC DENTAL HEALTH ASSOCIATES OF VIRGINIA,PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DYNAMIC DENTAL HEALTH ASSOCIATES OF VIRGINIA",
        "enumeration_date": "2013-10-16",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "SCHIAPARELLI",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "727-800-8040"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700145001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Road Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.