Bass & Kamp South Main LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BASS & KAMP SOUTH MAIN LLC

Doing business as

New River Dental Associates

Practice address

210 Professional Park Dr SE Ste 11
Blacksburg, VA 24060-6649

Phone

(540) 951-3989

NPI assigned

Jan 13, 2020

Last updated

Jan 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Neil Tebbenkamp, DDS

Title

Member

Phone

(540) 838-5050

Specialties & licenses 1

Addresses

Other names 1

• New River Dental Associates Doing business as

Practitioners 1

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.

• Charles Edward Harris, D.D.S.

  • General Practice Dentistry
  • Blacksburg, VA
  • NPI 1801935721
  NPD (past)

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1306486840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 PROFESSIONAL PARK DR SE STE 11",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 PROFESSIONAL PARK DR SE STE 11",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606649",
            "telephone_number": "540-951-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASS & KAMP SOUTH MAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "TEBBENKAMP",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "540-838-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New River Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Renee Banks
• Lillian Banks, LCSW
• Colleen Mary Bannigan, DO
• Diane Marie Barbernitz, M.S.
• Harvey Michael Barker, PH.D.
• Jay Marshall Bass, DDS
• Kimberly Bassler, PT, DPT
• Kristen Trump Battaglia, OTR/L
• Heather Lynn Bayless, NP-C
• Taylor Beasley, LPC

• Dental Clinic/Center in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.