Active NPI
Dale P Shewmaker DDS PC
- General Practice Dentistry
- Fairfax, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401005882
- 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
- Last updated
- Nov 12, 2015
- Organization subpart
- Yes
- Parent organization
- POTOMAC VALLEY DENTAL CARE, PLLC
NPPES NPI Registry
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
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401005882 | VA | Primary |
Addresses
Primary practice location
10623 Braddock Rd
Fairfax, VA 22032-2202
Mailing address
10623 Braddock Rd
Fairfax, VA 22032-2202
Phone (703) 385-6960
National Provider Directory
National Provider Directory- Part of
- Potomac Valley Dental Care PLLC
Locations
10623 Braddock Rd
Fairfax, VA 22032
Phone (703) 385-6960
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.
-
- Dentist
- Centreville, VA
- NPI 1013387737
Practitioners & affiliated clinicians
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.
-
- General Practice Dentistry
- Fairfax, VA
- NPI 1932264587
NPI Registry JSON
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": []
}Other providers in Fairfax, VA
Sources for this page
- 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.