NPIMap

Organization Active NPI

Danville Dental Associates, PC

  • General Practice Dentistry
  • Danville, VA
National Provider Identifier
1306343868
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401410725 Issued in VA
Legal business name
DANVILLE DENTAL ASSOCIATES, PC
Practice address
5011 Riverside Dr Ste B
Danville, VA 24541-5642
Phone
(434) 822-1332
Fax
(434) 822-1336
NPI assigned
Apr 11, 2018
Last updated
Aug 9, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
DANVILLE DENTAL ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Authorized official

Name
Dr. Christopher A Payne, DDSNPI 1770583106
Title
Dentist
Phone
(434) 822-1332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 0401410725 VA Primary

Addresses

Primary practice location

5011 Riverside Dr Ste B
Danville, VA 24541-5642

Mailing address

5011 Riverside Dr Ste B
Danville, VA 24541-5642
Phone (434) 822-1332

Other identifiers 1

IdentifierTypeStateIssuer
1770583106OtherVANPI

Other names 1

  • Danville Dental Associates RSLL Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180628000126 VA DME Supplier - Oral Surgery - Dentist 4789997826 Practice locations: Danville, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Danville Dental Assoc PC2 organizations share this tax ID, including this one
Part of
Danville Dental Assoc PC

Other organizations with this tax ID 1

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

Locations

5011 Riverside Dr
Ste B
Danville, VA 24541
Phone (434) 822-1332

770 Piney Forest Rd
Danville, VA 24540
Phone (434) 799-8825

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 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1306343868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 RIVERSIDE DR STE B",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245415642",
            "telephone_number": "434-822-1332",
            "fax_number": "434-822-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 RIVERSIDE DR STE B",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245415642",
            "telephone_number": "434-822-1332",
            "fax_number": "434-822-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE DENTAL ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DANVILLE DENTAL ASSOCIATES, PC",
        "enumeration_date": "2018-04-11",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "434-822-1332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770583106",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Danville Dental Associates RSLL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.