NPIMap

Organization Active NPI

Pediatric Dentistry of Virginia, PLLC

  • Pediatric Dentistry
  • Mechanicsville, VA
National Provider Identifier
1295964955
Registry record updated Oct 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401412165 Issued in VA
Legal business name
PEDIATRIC DENTISTRY OF VIRGINIA, PLLC
Practice address
8203 Center Path Lane
Suite a
Mechanicsville, VA 23116
Phone
(804) 746-7382
Fax
(804) 746-3025
NPI assigned
Jul 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2009

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

Authorized official

Name
Dr. Andrew D Zima Jr., DDS
Title
Pediatric Dentist
Phone
(804) 746-7382

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 0401412165 VA Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 0401411085 VA

Addresses

Primary practice location

8203 Center Path Lane
Suite a
Mechanicsville, VA 23116

Mailing address

8203 Center Path Lane
Suite a
Mechanicsville, VA 23116
Phone (804) 746-7382

Other identifiers 1

IdentifierTypeStateIssuer
9179294MedicaidVA

Other names 1

  • Hanover Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Virginia Dental Care PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

8203 Center Path Ln
#A
Mechanicsville, VA 23116
Phone (804) 746-7382

Practitioners & affiliated clinicians

Practitioners 1

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": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255219200000",
    "number": "1295964955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8203 CENTER PATH LANE",
            "address_2": "SUITE A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "23116",
            "telephone_number": "804-746-7382",
            "fax_number": "804-746-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8203 CENTER PATH LANE",
            "address_2": "SUITE A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "23116",
            "telephone_number": "804-746-7382",
            "fax_number": "804-746-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF VIRGINIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-10-11",
        "status": "A",
        "authorized_official_last_name": "ZIMA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "804-746-7382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401412165",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401411085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179294",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hanover Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2009; 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.