Dale P Shewmaker DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401005882 Issued in VA

Legal business name

DALE P SHEWMAKER DDS PC

Practice address

10623 Braddock Rd
Fairfax, VA 22032-2202

Phone

(703) 385-6960

NPI assigned

Nov 12, 2015

Organization subpart

Yes

Parent organization

POTOMAC VALLEY DENTAL CARE, PLLCAs reported in NPPES

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

Authorized official

Name

Dr. Dale P Shewmaker, DDS

Title

Dentist/Owner

Phone

(703) 385-6960

Specialties & licenses 1

Addresses

Part of

Giovanni P Iuculano DDS PC

Locations

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.

• Potomac Valley Dental Care PLLC

  • Dentist
  • Centreville, VA
  • NPI 1013387737
  NPPES parent name

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1356714331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10623 BRADDOCK RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322202",
            "telephone_number": "703-385-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10623 BRADDOCK RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220322202",
            "telephone_number": "703-385-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE P SHEWMAKER DDS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POTOMAC VALLEY DENTAL CARE, PLLC",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "SHEWMAKER",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "703-385-6960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamed Dahbi, PHARM D
• Diana Dahlgren, PH.D.
• Alysa Daigle, MS/CAGS, NCSP
• Laura Dailey
• Sumaya Dakhil
• Olympia P Dallas, MD
• Elizabeth Dalrymple, RN, MSN, CDCES
• Alexandra Daly
• Jean Daly
• Susan K Daly, MSW

• All providers in Fairfax, VA
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.